Evaluation of Prescription Pattern of Antihypertensives and Its Compliance with Joint National Committee 8 Guidelines in Hospital Setting.

Abstract

Globally, hypertension is a major noncommunicable disease that contributes to significant fatalities and morbidity. Evaluation of trends in the prescription of antihypertensives and their adherence to the Joint National Commission 8 (JNC 8) recommendations can provide perspective on the dissemination of local and international guidelines in real-world clinical practice. An ambispective observational study was conducted over a duration of 6 months. Among the three-drug combinations, angiotensin receptor blockers (ARB) + beta-blocker (BB) + calcium channel blocker (CCB) (10%), followed by ARB + CCB + diuretic (DU) (8%), were primarily prescribed. BB + diuretic (DU) (20%) was the most prescribed in two-drug combination therapy, followed by ARB + BB (19%). BB (46%) were the most prescribed drugs, followed by diuretics (25%) as monotherapy. Combination therapy is as efficient as single-drug therapy. Among patients with hypertension and heart failure with reduced ejection fraction (HFrEF), the ARNI/ARB combination is effective in HFrEF patients. ARNI/ARB + antihypertensives were most commonly prescribed (40%), followed by ARNI/ARB + ivabradine + antihypertensives (35%). Adherence to the JNC 8 guidelines varied between 71 and 92%. Ninety-two percent of the prescriptions were adherent to initiating pharmacological treatment in patients aged over 60 years with a BP goal of <140/90, with thiazide/loop diuretics, CCB, and ACEI/ARB as first-line therapy. The pattern of prescribed drugs was in accordance with clinical guidelines. Compliance with JNC 8 guidelines was optimal. However, studies including larger patient populations, drug dosages used, and physician perspectives on prescribing need to be studied further.