Ps-c36-12: prescription pattern of antihypertensive medications, compliance and control of blood pressure among hypertensive outpatients at tertiary cardiac hospital in bangladesh

Objectives: Blood pressure control in hypertensive patients depends not only on antihypertensive medications but drug compliance and lifestyle changes. The aim of the study is to look at the commonly used antihypertensive drugs and patients adherence to drug and lifestyle modification and their blood pressure control. Method: This is a cross sectional descriptive study among known hypertensive patients visited at hypertension clinic at National Heart Foundation Hospital and Research institute. Data was collected and entered according to structured questionnaire in software. Then data was analyzed using SPSS 20. Result: A total number of 920 patients were included in this study. Male and female were almost equal, 468 (50.9%) and 452 (49.1%) respectively. Mean age was 49.1 + 12.33 (min. 14 years and max. 90 years). Body mass index (BMI) is 26.57(+3.97) with 21% has obesity. 19% of patients were current smokers (male to female, 14.89% to 5.1%) and 8.1% are smokeless tobacco users. 14% of patient consume extra salt in main meal. Among other risk factors diabetes mellitus was 5.86% (54 patients), dyslipidemia was 2.3% (in 21 patients) and family history was positive in 78 patients (8.5%), chronic kidney disease was noted in < 1%. Mean duration of hypertension was 5.44 (+5.29) years. Single drug was prescribed in 246 (26.7%) patients where ARB prescribed in 119 (12.9%) patients followed by betablocker in 60 (6.5%) and CCB in 38 (4.1%) patients. ARB and CCB were used most (78 patients, 8.5%) as combination of dual drug (or single pill combination), followed by betablocker and CCB combination in 47 (5.1%) patients and ARB and betablocker in 38 (4.1%) patients. ARB, betablocker and CCB were used combinedly in 44 (4.8%) patients when three drugs were used. Overall, most commonly used antihypertensive drug was amlodipine in 188 (20.4%) patients followed by losartan potassium (15.2%), Olmesartan (13.3%) and Bisoprolol (10.9%). Out of 920 patients 171 (18.6%) were non-adherent to drug in whom control of blood pressure is poor (28.2% vs 7.3%, p. < 0.0001) and almost similar was seen in patients who were non-adherent to lifestyle changes (280 patients, 30.4%) (uncontrol vs control, 33.3% vs 27.1%, p < 0.04). Conclusion: Prescribing drugs is not enough to control hypertension. Drug compliance and adherence to lifestyle modification are important part of management plan that every physician should give emphasis to improve blood pressure control among hypertensive patients.