Prescribing Pattern and Effectiveness of Antihypertensives in Patients Suffering from Hypertension to Diabetes Mellitus with and without Compelling Indications in Tertiary Care Hospital.

Abstract

Aim: The prevalence of hypertension (HTN) and diabetes mellitus (DM) is increasing worldwide, and their coexistence is well-documented. Managing both conditions is challenging due to shared pathophysiological mechanisms and the need to balance blood pressure (BP) control with glycemic management. The objective of this protocol was to consider the prescribing pattern and effectiveness of antihypertensive agents in hypertensive and diabetic patients, with and without compelling indications, at tertiary care hospital. Materials and methods: A prospective, observational study was conducted over 6 months in total 226 diabetic hypertensive patients from a tertiary care hospital. Demographic and medication history data were collected using a self-designed patient profile form. Descriptive statistics were used to analyze the data, and the results were expressed as percentages or means with standard deviations. Results: A total of 226 patients were included in the study, with 62% males and 38% females. 73% of patients were classified as stage 1 and 27% as stage 2 HTN. Among the prescribed antihypertensive agents, β-blockers (BBs) were the most prescribed, followed by angiotensin receptor blockers (ARBs), calcium channel blockers (CCBs), angiotensin-converting enzyme inhibitors (ACEIs), diuretics, and other classes. Combination therapy was predominantly used, with dual-drug therapy being the most common. Compelling indications for antihypertensive treatment included ischemic heart disease (IHD) (38.49%), chronic kidney disease (CKD) (12.38%), and stroke (6.63%). The choice of antihypertensive agents varied based on the presence of compelling indications, with BBs and ARBs being frequently prescribed. BP control was achieved in 93% of the patients, with 85.96% of patients with HTN + DM, and 82.84% of patients with additional compelling indications having controlled BP. Conclusion: Therefore, it can be concluded that the antihypertensive medications prescribed to the study adhered to guidelines and that long-term use of these combinations proved to be more effective, safe, and well-tolerated for patients with HTN and DM with or without convincing indications. Adopting the best approach to managing HTN in people with diabetes is crucial for ameliorating patient outcomes and enhancing overall quality of life.