Vol 12, No 5 (2008)
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Published online: 2008-10-12

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The number and types of hypotensive drugs prescribed for patients with poorly controlled arterial hypertension admitted to specialized units

Małgorzata Wajdlich, Maja Waszczyk, Tomasz Jarzębski, Ilona Kurnatowska, Michał Nowicki
Nadciśnienie tętnicze 2008;12(5):367-373.

Abstract

Background Both untreated or inadequately controlled arterial hypertension is a serious risk factor of cardiovascular diseases and target organ complications. According to the ESH/ESC guidelines, all patients with AH (arterial hypertension) stage 2. or 3. require chronic antihypertensive therapy. The aim of the study was to retrospectively evaluate the number and classes of antihypertensive drugs administered to the patients discharged from hospital who were hospitalized due to uncontrolled hypertension.
Material and methods The retrospective evaluation of the number and classes of prescribed antihypertensive drugs on discharge from hospital was based on medical records of 350 patients (210 women - F, age 62 ± 16 years; 140 men - M, age 54 ± 15 years), admitted to the hypertension reference center in the years 2004-2007 due to high blood pressure (≥ 180/100 mm Hg).
Results 83.4% of patients received angiotensin converting enzyme inhibitors; and than in order of decreasing frequency: adrenergic b-antagonists, Ca-channel blockers, diuretics, clonidine, adrenergic a-antagonists. Aldosterone antagonists were prescribed to 17.1% and angiotensin type- 1 receptor antagonist was prescribed to 13.7% of patients. In the analyzed period the administration of angiotensin type-1 receptor antagonists significant increased from year to year and we observed tendency to more frequent use of angiotensin converting enzyme inhibitors, in parallel to a decreasing frequency of b-blockers use. The percentage of patients who require 1 drug to normalize blood pressure was 4%, 2 drugs 16.3%, 3 drugs - 26.9% and 4 and more 52%. The normalization of blood pressure values to <140/90 mm Hg was observed only in 64% of patients.
Conclusions The most common class of prescribed drugs was angiotensin converting enzyme inhibitors. The patients with AH stage 2 and 3 often require antihypertensive pharmacotherapy with 4 or more drugs to normalize blood pressure.

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