A Study of Anti-hypertensive Drug Prescription Patterns in Hypertensive Post-menopausal women
Background: Drug prescription in menopause is complex as estrogen deficiency, hypertension (HT) and other risk factors, rapidly increase the risk of cardiovascular diseases (CVD) in post-menopausal women (PMW).Objectives: To evaluate the prescription trends of anti-hypertensive drugs in PMW.Methods: This was an observational, cross sectional study conducted over a period of 1 year, on hypertensive PMW. The prescriptions were evaluated for antihypertensive drug use patterns and also as per WHO core drug indicators.Results: 21.82% of prescriptions had monotherapy, amongst which angiotensin receptor blockers (ARB) (10%) and individually, telmisartan (5.45%) were most commonly prescribed. Majority of prescriptions had two drug therapy (44.09%), among which ARB + beta-blockers (BB) (20.91%) and individually, Telmisartan + Metoprolol (13.64%) were most frequently prescribed. ARB + Diuretic (DI) (9.55%) was the most common fixed drug combination (FDC) prescribed. ARB + BB + DI (10.45%), ARB + 2DI + BB (4.09%) and ARB + 2DI + BB + Calcium channel blocker (1.82%) were most commonly prescribed three, four and ≥five drug combinations, respectively. Hypolipidemic drugs (60.45%) were maximally co-prescribed. Percentage of drugs prescribed by generic name was 4.63% and from essential drug list was 32.62%.Conclusions: A high trend of polypharmacy was observed in hypertensive PMW. HT, being a multifactorial disease, deserves a multidisciplinary and a comprehensive approach in the care of this population subgroup. Knowledge of prescription pattern and thus the rational utilisation of drugs will help achieve better control rates of HT and hence curb down the burden of CVDs in PMW.
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
How to Cite
Singla, R., Singh, H., Gupta, A. K., & Sehgal, V. K. (2018). A Study of Anti-hypertensive Drug Prescription Patterns in Hypertensive Post-menopausal women. International Journal of Medical and Dental Sciences, 1594–1603. https://doi.org/10.18311/ijmds/2018/18907
- Matthews KA, Kuller LH, Sutton-Tyrrell K, Chang YF. Changes in cardiovascular risk factors during the perimenopause and postmenopause and carotid artery atherosclerosis in healthy women. Stroke 2001;32(5):1104-11.
- Howkins, Bourne. Shaw’s textbook of Gynaecology. 16th ed. Padubidri VG, Daftary SN, editors. India: Elsevier; 2015.p.65-78.
- Awotidebe TO, Adedoyin RA, Olola IL, Adeyeye VO, Akinola OT, Mbada CE, et al. Cardiovascular Risk Profile of Post-Menopausal Women in a Semi-Urban Community in Nigeria. Br J Med Med Res 2014;4(29):4780-90.
- Hanfy HM, Awad MA, Gharieb HO. Effect of Acupressure on Postmenopausal Hypertension. Bull Fac Ph Th Cairo Univ 2011;16(2):1-7.
- Robitaille NM. Hypertension in women. Can J Cardiol 1996;12 Suppl D:6D-8D.
- Gu Q, Burt VL, Paulose-Ram R, Dillon CF. Gender differences in hypertension treatment, drug utilization patterns, and blood pressure control among US adults with hypertension: data from the National Health and Nutrition Examination Survey 1999–2004. Am J Hypertens 2008;21(7):789-98.
- Stamler R. Implications of the INTERSALT study. Hypertens 1991;17 Suppl 1:S16-20.
- Tandon VR, Sharma S, Mahajan S, Mahajan A, Khajuria V, Mahajan V, et al. Antihypertensive drug prescription patterns, rationality, and adherence to Joint National Committee-7 hypertension treatment guidelines among Indian postmenopausal women. J Mid-life Health 2014;5:78-83.
- Patta S. Drug Utilization Pattern of Antihypertensives in Geriatric and Non-Geriatric Population in a Tertiary Care Government Hospital Srikakulum, APJ Evol Med and Dent Sci 2015;4(13):2101-6.
- World Health Organization. Introduction to Drug Utilization Research [Internet]. Geneva: World Health Organization. 2003 – [Cited 2017 Sept]. Available from: http://apps.who.int/medicinedocs/pdf/s4876e/s4876e.pdf.
- National List of Essential Medicines 2015. [Internet]. India: National List of Essential Medicines. 2015 - [Cited 2017 Oct]. Available from: http://cdsco.nic.in/WriteReadData/NLEM2015/NLEM,%202015.pdf.
- Sharma AK, Dahiya N, Kairi JK, Bharati SM. Prescription patterns of antihypertensive drugs in a tertiary care hospital in India. Int J Basic Clin Pharmacol 2015;4(1):55-9.
- National High Blood Pressure Education Program. The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure [Internet]. Bethesda (MD): National Heart, Lung, and Blood Institute (US). 2004 Aug - [Cited 2017 Aug 26]. Available from: https://www.nhlbi.nih.gov /files/docs/guidelines/jnc7full.pdf.
- Kalra S, Kalra B, Agrawal N. Combination therapy in hypertension: An update. Diabetol Metab Syndr 2010;2(1):44.
- Panja M, Mondal S, Bhattacharya P, Mondal D. Beta Blocker in Combination with Other Antihypertensives. Supplement of JAPI 2009;57:35-7.
- Tiwari H, Kumar A, Kulkarni SK. Prescription monitoring of anti-hypertensive drug utilization at the Panjab University Health Centre in India. Singapore Med J 2004;45(3):117-20.
- Che Q, Schreiber MJ Jr, Rafey MA. Beta-blockers for hypertension: are they going out of style? Cleve Clin J Med 2009;76(9):533-42.
- Sutters M. Systemic Hypertension. In: Papadakis MA, McPhee SJ, Rabow MW, editors. Current Medical Diagnosis & Treatment. 52nd ed. New York: McGraw Hill; 2013.p.433-63.
- Jeschke E, Ostermann T, Tabali M, Vollmar HC, Kröz M, Bockelbrink A, et al. Evaluation of prescribing patterns in a German network of CAM physicians for the treatment of patients with hypertension: a prospective observational study. BMC Fam Pract 2009;10:78-91.
- Skolnik NS, Beck JD, Clark M. Combination Antihypertensive Drugs: Recommendations for Use. Am Fam Physician 2000;61(10):3049-56.
- Cidda M, Mateti UV, Batchu MK, Martha S. Study of prescribing patterns of antihypertensives in South Indian population. Int J Basic Clin Pharmacol 2014;3(2):303-7.
- Sivakumar A, Venkateswaramurthy N, Sambathkumar R. Study of drug prescription pattern of anti-hypertensives in a tertiary care hospital. Der Pharmacia Lettre 2014;6(4):86-8.
- Beg MA, Dutta S, Varma A, Kant R, Bawa S, Anjoom M, et al. A study on drug prescribing pattern in hypertensive patients in a tertiary care teaching hospital at Dehradun, Uttarakhand. Int J Med Sci Public Health 2014;3(8):922-6.
- Tamuno I, Fadare J. Drug treatment for hypertension in a tertiary health care facility in northern Nigerian. Int J Pharm Biomed Res 2011;2(2):104-9.