STUDY OF PRESCRIPTION PATTERNS OF ANTIHYPERTENSIVE AGENTS IN TERTIARY CARE TEACHING HOSPITAL
Main Article Content
Keywords
Hypertension, Antihypertensive drugs, Prescribing patterns, Fixed-dose combinations, WHO drug use indicators, Polypharmacy, Rational drug use, Essential medicines, Drug utilization, Pharmacotherapy
Abstract
Background: Hypertension is a major public health concern requiring effective pharmacological management. This study aimed to evaluate the prescribing patterns of antihypertensive drugs and adherence to treatment guidelines in a tertiary care hospital. Methods: A cross-sectional observational study was conducted from June 2023 to June 2024 in the outpatient department of medicine at Santosh Medical College and Hospital, Ghaziabad. Ethical approval was obtained, and 1027 hypertensive patient prescriptions were analyzed based on predefined inclusion and exclusion criteria. Prescription data were assessed using WHO drug use indicators, and statistical analysis was performed using SPSS, with categorical variables analyzed via the chi-square test. Results: A total of 2978 drugs were prescribed, of which 1086 (36.5%) were antihypertensive agents, with an average of 1.67 antihypertensive drugs per prescription. Only 24.40% were prescribed by their generic name, and fixed-dose combinations (FDCs) were included in 41.70% of prescriptions. Injectable antihypertensive use was minimal (2.11%), while 68.82% of antihypertensive drugs were from the National List of Essential Medicines (NLEM 2020). Polypharmacy was observed in 91.70% of cases. The most commonly prescribed antihypertensive drug classes were Angiotensin Receptor Blockers (40.15%) and Calcium Channel Blockers (38.21%), with Telmisartan (37.48%) and Amlodipine (31.31%) being the most frequently prescribed individual drugs. Dual therapy was the most common treatment approach (45.28%), followed by monotherapy (39.73%). The chi-square test revealed no significant association between therapy type and drug class distribution (p = 0.648). Conclusion: The study highlights prescribing trends in hypertension management, emphasizing a preference for brand-name medications, a high prevalence of polypharmacy, and frequent use of combination therapy. Addressing gaps in generic prescribing and ensuring rational drug use can optimize hypertension treatment outcomes and reduce healthcare costs.
References
1. Mills KT, Stefanescu A, He J. The global epidemiology of hypertension. Nat Rev Nephrol. 2020 Apr;16(4):223-237. doi: 10.1038/s41581-019-0244-2. Epub 2020 Feb 5. PMID: 32024986; PMCID: PMC7998524.
2. Bromfield S, Muntner P. High blood pressure: the leading global burden of disease risk factor and the need for worldwide prevention programs. Curr Hypertens Rep. 2013 Jun;15(3):134-6. doi: 10.1007/s11906-013-0340-9. PMID: 23536128; PMCID: PMC3699411.
3. NCD Risk Factor Collaboration (NCD-RisC). Worldwide trends in hypertension prevalence and progress in treatment and control from 1990 to 2019: a pooled analysis of 1201 population-representative studies with 104 million participants. Lancet. 2021 Sep 11;398(10304):957-980. doi: 10.1016/S0140-6736(21)01330-1. Epub 2021 Aug 24. Erratum in: Lancet. 2022 Feb 5;399(10324):520. doi: 10.1016/S0140-6736(22)00061-7. PMID: 34450083; PMCID: PMC8446938.
4. Sreeniwas Kumar A, Sinha N. Cardiovascular disease in India: A 360 degree overview. Med J Armed Forces India. 2020 Jan;76(1):1-3. doi: 10.1016/j.mjafi.2019.12.005. Epub 2020 Jan 13. PMID: 32020960; PMCID: PMC6994761.
5. Ramakrishnan S, Zachariah G, Gupta K, Shivkumar Rao J, Mohanan PP, Venugopal K, Sateesh S, Sethi R, Jain D, Bardolei N, Mani K, Kakar TS, Kidambi B, Bhushan S, Verma SK, Bhargava B, Roy A, Kothari SS, Gupta R, Bansal S, Sood S, Nath RK, Tyagi S, Gupta MD, Girish MP, Kalra IPS, Wander GS, Gupta S, Mandal S, Senguttuvan NB, Subramanyam G, Roy D, Datta S, Ganguly K, Routray SN, Mishra SS, Singh BP, Bharti BB, Das MK, Kumar S, Goswami KC, Bahl VK, Chandra S, Banerjee A, Guha S, Deb PK, Chopra HK, Deedwania P, Seth A; CSI-Great India BP Campaign Investigators. Prevalence of hypertension among Indian adults: Results from the great India blood pressure survey. Indian Heart J. 2019 Jul-Aug;71(4):309-313. doi: 10.1016/j.ihj.2019.09.012. Epub 2019 Sep 18. PMID: 31779858; PMCID: PMC6890959.
6. Carey RM, Wright JT Jr, Taler SJ, Whelton PK. Guideline-Driven Management of Hypertension: An Evidence-Based Update. Circ Res. 2021 Apr 2;128(7):827-846. doi: 10.1161/CIRCRESAHA.121.318083. Epub 2021 Apr 1. PMID: 33793326; PMCID: PMC8034801.
7. Heidari B, Avenatti E, Nasir K. Pharmacotherapy for Essential Hypertension: A Brief Review. Methodist Debakey Cardiovasc J. 2022 Dec 6;18(5):5-16. doi: 10.14797/mdcvj.1175. PMID: 36561082; PMCID: PMC9733188.
8. Evbayekha EO, Okobi OE, Okobi T, Ibeson EC, Nwafor JN, Ozobokeme OE, Olawoye A, Ngoladi IA, Boms MG, Habib FA, Oyelade BO, Okoroafor CC, Chukwuma VN, Alex KB, Ohikhuai EE. The Evolution of Hypertension Guidelines Over the Last 20+ Years: A Comprehensive Review. Cureus. 2022 Nov 13;14(11):e31437. doi: 10.7759/cureus.31437. PMID: 36523741; PMCID: PMC9746526.
9. Chobanian AV, Bakris GL, Black HR, Cushman WC, Green LA, Izzo JL Jr, Jones DW, Materson BJ, Oparil S, Wright JT Jr, Roccella EJ; National Heart, Lung, and Blood Institute Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure; National High Blood Pressure Education Program Coordinating Committee. The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure: the JNC 7 report. JAMA. 2003 May 21;289(19):2560-72. doi: 10.1001/jama.289.19.2560. Epub 2003 May 14. Erratum in: JAMA. 2003 Jul 9;290(2):197. PMID: 12748199.
10. James PA, Oparil S, Carter BL, Cushman WC, Dennison-Himmelfarb C, Handler J, Lackland DT, LeFevre ML, MacKenzie TD, Ogedegbe O, Smith SC Jr, Svetkey LP, Taler SJ, Townsend RR, Wright JT Jr, Narva AS, Ortiz E. 2014 evidence-based guideline for the management of high blood pressure in adults: report from the panel members appointed to the Eighth Joint National Committee (JNC 8). JAMA. 2014 Feb 5;311(5):507-20. doi: 10.1001/jama.2013.284427. Erratum in: JAMA. 2014 May 7;311(17):1809. PMID: 24352797.
11. Al-Makki A, DiPette D, Whelton PK, Murad MH, Mustafa RA, Acharya S, Beheiry HM, Champagne B, Connell K, Cooney MT, Ezeigwe N, Gaziano TA, Gidio A, Lopez-Jaramillo P, Khan UI, Kumarapeli V, Moran AE, Silwimba MM, Rayner B, Sukonthasan A, Yu J, Saraffzadegan N, Reddy KS, Khan T. Hypertension Pharmacological Treatment in Adults: A World Health Organization Guideline Executive Summary. Hypertension. 2022 Jan;79(1):293-301. doi: 10.1161/HYPERTENSIONAHA.121.18192. Epub 2021 Nov 15. PMID: 34775787; PMCID: PMC8654104.
12. Paz MA, de-La-Sierra A, Sáez M, Barceló MA, Rodríguez JJ, Castro S, Lagarón C, Garrido JM, Vera P, Coll-de-Tuero G. Treatment efficacy of anti-hypertensive drugs in monotherapy or combination: ATOM systematic review and meta-analysis of randomized clinical trials according to PRISMA statement. Medicine (Baltimore). 2016 Jul;95(30):e4071. doi: 10.1097/MD.0000000000004071. PMID: 27472680; PMCID: PMC5265817.
13. Ofori-Asenso R, Agyeman AA. Irrational Use of Medicines-A Summary of Key Concepts. Pharmacy (Basel). 2016 Oct 28;4(4):35. doi: 10.3390/pharmacy4040035. PMID: 28970408; PMCID: PMC5419375.
14. Garg M, Vishwakarma P, Sharma M, Nehra R, Saxena KK. The impact of irrational practices: A wake up call. J Pharmacol Pharmacother. 2014 Oct;5(4):245-7. doi: 10.4103/0976-500X.142434. PMID: 25422564; PMCID: PMC4231553.
15. Joshi R, Medhi B, Prakash A, Chandy S, Ranjalkar J, Bright HR, Basker J, Govindraj L, Chugh PK, Tripathi CD, Badyal DK, Balakrishnan S, Jhaj R, Shukla AK, Atal S, Najmi A, Banerjee A, Kamat S, Tripathi RK, Shetty YC, Parmar U, Rege N, Dikshit H, Mishra H, Roy SS, Chatterjee S, Hazra A, Bhattacharya M, Das D, Trivedi N, Shah P, Chauhan J, Desai C, Gandhi AM, Patel PP, Shah S, Sheth S, Raveendran R, Mathaiyan J, Manikandan S, Jeevitha G, Gupta P, Sarangi SC, Yadav HN, Singh S, Kaushal S, Arora S, Gupta K, Jain S, Cherian JJ, Chatterjee NS, Kaul R, Kshirsagar NA. Assessment of prescribing pattern of drugs and completeness of prescriptions as per the World Health Organization prescribing indicators in various Indian tertiary care centers: A multicentric study by Rational Use of Medicines Centers-Indian Council of Medical Research network under National Virtual Centre Clinical Pharmacology activity. Indian J Pharmacol. 2022 Sep-Oct;54(5):321-328. doi: 10.4103/ijp.ijp_976_21. PMID: 36537400; PMCID: PMC9846909.
16. Gama, Helena. (2007). Drug utilization studies. Arq Med. 22.
17. Wettermark, Bjorn & Elseviers, Monique & Almarsdóttir, Anna Birna & Andersen, Morten & Benko, Ria & Bennie, Marion & Eriksson, Irene & Godman, Brian & Krska, Janet & Poluzzi, Elisabetta & Taxis, Katja & Vander Stichele, Robert & Vlahovic-Palcevski, Vera. (2016). Introduction to drug utilization research. 10.1002/9781118949740.ch1.
18. Neville H, Trenaman SC. Drug Utilization Research: Methods and Applications. Can J Hosp Pharm. 2017 Jul-Aug;70(4):325. Epub 2017 Aug 31. PMCID: PMC5587052.
19. Nitya S, Ramya G, Kiruthika S, Meenakshi R, Devi JN, Suganya G, Pravin S. Drug utilization pattern and factors associated with polypharmacy and excessive polypharmacy in geriatric medical out-patients at a rural health training centre in India. J Family Med Prim Care. 2021 Jul;10(7):2636-2641. doi: 10.4103/jfmpc.jfmpc_2417_20. Epub 2021 Jul 30. PMID: 34568148; PMCID: PMC8415691.
20. Fuchs FD, Whelton PK. High Blood Pressure and Cardiovascular Disease. Hypertension. 2020 Feb;75(2):285-292. doi: 10.1161/HYPERTENSIONAHA.119.14240. Epub 2019 Dec 23. PMID: 31865786; PMCID: PMC10243231.
21. Kario, K., Okura, A., Hoshide, S. et al. The WHO Global report 2023 on hypertension warning the emerging hypertension burden in globe and its treatment strategy. Hypertens Res 47, 1099–1102 (2024). https://doi.org/10.1038/s41440-024-01622-w
22. Anchala R, Kannuri NK, Pant H, Khan H, Franco OH, Di Angelantonio E, Prabhakaran D. Hypertension in India: a systematic review and meta-analysis of prevalence, awareness, and control of hypertension. J Hypertens. 2014 Jun;32(6):1170-7. doi: 10.1097/HJH.0000000000000146. PMID: 24621804; PMCID: PMC4011565.
23. Giezendanner S, Tschudi P, Leuppi J, Dieterle T, Zeller A. Effect of guideline revisions by the Swiss Society of Hypertension on blood pressure control in hypertensive patients from primary care. Swiss Med Wkly. 2020 Jun 29;150:w20279. doi: 10.4414/smw.2020.20279. PMID: 32657419.
24. Satheesh G, Dhurjati R, Balagopalan JP, Mohanan PP, Salam A. Comparison of Indian clinical practice guidelines for the management of hypertension with the World Health Organization, International Society of Hypertension, American, and European guidelines. Indian Heart J. 2024 Jan-Feb;76(1):6-9. doi: 10.1016/j.ihj.2023.12.009. Epub 2024 Jan 1. PMID: 38171390; PMCID: PMC10943557.
25. Mukete BN, Ferdinand KC. Polypharmacy in Older Adults With Hypertension: A Comprehensive Review. J Clin Hypertens (Greenwich). 2016 Jan;18(1):10-8. doi: 10.1111/jch.12624. Epub 2015 Jul 27. PMID: 26215211; PMCID: PMC8031793.
26. Mohammad R, Bansod DW. Hypertension in India: a gender-based study of prevalence and associated risk factors. BMC Public Health. 2024 Oct 1;24(1):2681. doi: 10.1186/s12889-024-20097-5. PMID: 39354462; PMCID: PMC11443669.
27. Mohanty P, Patnaik L, Nayak G, Dutta A. Gender difference in prevalence of hypertension among Indians across various age-groups: a report from multiple nationally representative samples. BMC Public Health. 2022 Aug 10;22(1):1524. doi: 10.1186/s12889-022-13949-5. PMID: 35948916; PMCID: PMC9364494.
28. Alexander T, Hiremath JS, Swahney JPS, Chandra S, Jain P, Chandra P, Sinha N, Sashikanth T, Bachhu Y, Balachandran A, Jayagopal PB, Unni TG, Nair T, Kannan K, Prabhakar D, Chenniappan M, Mahajan AU, Karnik RD, Ponde CK, Advani P, Khan IA, Goyal BM, Vaidyanathan PR, Prajapati H, Verberk WJ. Identifying Drug Prescription in Newly Diagnosed Hypertension Patients in India. J Clin Hypertens (Greenwich). 2025 Jan;27(1):e14963. doi: 10.1111/jch.14963. PMID: 39822165; PMCID: PMC11771799.
29. Abdelkader NN, Awaisu A, Elewa H, El Hajj MS. Prescribing patterns of antihypertensive medications: A systematic review of literature between 2010 and 2020. Explor Res Clin Soc Pharm. 2023 Aug 5;11:100315. doi: 10.1016/j.rcsop.2023.100315. PMID: 37635839; PMCID: PMC10448163.
30. Jadhav U, Mohanan PP, Almeida AF, Abraham G, Khan MY, Gaurav K, Mane A, Vikas S, Jain M, Meel B. Effectiveness and Effect on Renal Parameters of Amlodipine vs. Other Dihydropyridine Calcium Channel Blockers in Patients with Essential Hypertension: Retrospective Observational Study Based on Real-World Evidence from Electronic Medical Records. Cardiol Ther. 2021 Dec;10(2):465-480. doi: 10.1007/s40119-021-00224-8. Epub 2021 Jun 11. PMID: 34115326; PMCID: PMC8555025.
31. Delara M, Murray L, Jafari B, Bahji A, Goodarzi Z, Kirkham J, Chowdhury M, Seitz DP. Prevalence and factors associated with polypharmacy: a systematic review and Meta-analysis. BMC Geriatr. 2022 Jul 19;22(1):601. doi: 10.1186/s12877-022-03279-x. Erratum in: BMC Geriatr. 2022 Sep 12;22(1):742. doi: 10.1186/s12877-022-03388-7. PMID: 35854209; PMCID: PMC9297624.
32. Takahashi T, Ono H, Ono Y, Ishimitsu T, Matsuoka H. Combination therapy with telmisartan and spironolactone alleviates L-NAME exacerbated nephrosclerosis with an increase in PPAR-gamma and decrease in TGF-beta(1). Int Heart J. 2007 Sep;48(5):637-47. doi: 10.1536/ihj.48.637. PMID: 17998773.
2. Bromfield S, Muntner P. High blood pressure: the leading global burden of disease risk factor and the need for worldwide prevention programs. Curr Hypertens Rep. 2013 Jun;15(3):134-6. doi: 10.1007/s11906-013-0340-9. PMID: 23536128; PMCID: PMC3699411.
3. NCD Risk Factor Collaboration (NCD-RisC). Worldwide trends in hypertension prevalence and progress in treatment and control from 1990 to 2019: a pooled analysis of 1201 population-representative studies with 104 million participants. Lancet. 2021 Sep 11;398(10304):957-980. doi: 10.1016/S0140-6736(21)01330-1. Epub 2021 Aug 24. Erratum in: Lancet. 2022 Feb 5;399(10324):520. doi: 10.1016/S0140-6736(22)00061-7. PMID: 34450083; PMCID: PMC8446938.
4. Sreeniwas Kumar A, Sinha N. Cardiovascular disease in India: A 360 degree overview. Med J Armed Forces India. 2020 Jan;76(1):1-3. doi: 10.1016/j.mjafi.2019.12.005. Epub 2020 Jan 13. PMID: 32020960; PMCID: PMC6994761.
5. Ramakrishnan S, Zachariah G, Gupta K, Shivkumar Rao J, Mohanan PP, Venugopal K, Sateesh S, Sethi R, Jain D, Bardolei N, Mani K, Kakar TS, Kidambi B, Bhushan S, Verma SK, Bhargava B, Roy A, Kothari SS, Gupta R, Bansal S, Sood S, Nath RK, Tyagi S, Gupta MD, Girish MP, Kalra IPS, Wander GS, Gupta S, Mandal S, Senguttuvan NB, Subramanyam G, Roy D, Datta S, Ganguly K, Routray SN, Mishra SS, Singh BP, Bharti BB, Das MK, Kumar S, Goswami KC, Bahl VK, Chandra S, Banerjee A, Guha S, Deb PK, Chopra HK, Deedwania P, Seth A; CSI-Great India BP Campaign Investigators. Prevalence of hypertension among Indian adults: Results from the great India blood pressure survey. Indian Heart J. 2019 Jul-Aug;71(4):309-313. doi: 10.1016/j.ihj.2019.09.012. Epub 2019 Sep 18. PMID: 31779858; PMCID: PMC6890959.
6. Carey RM, Wright JT Jr, Taler SJ, Whelton PK. Guideline-Driven Management of Hypertension: An Evidence-Based Update. Circ Res. 2021 Apr 2;128(7):827-846. doi: 10.1161/CIRCRESAHA.121.318083. Epub 2021 Apr 1. PMID: 33793326; PMCID: PMC8034801.
7. Heidari B, Avenatti E, Nasir K. Pharmacotherapy for Essential Hypertension: A Brief Review. Methodist Debakey Cardiovasc J. 2022 Dec 6;18(5):5-16. doi: 10.14797/mdcvj.1175. PMID: 36561082; PMCID: PMC9733188.
8. Evbayekha EO, Okobi OE, Okobi T, Ibeson EC, Nwafor JN, Ozobokeme OE, Olawoye A, Ngoladi IA, Boms MG, Habib FA, Oyelade BO, Okoroafor CC, Chukwuma VN, Alex KB, Ohikhuai EE. The Evolution of Hypertension Guidelines Over the Last 20+ Years: A Comprehensive Review. Cureus. 2022 Nov 13;14(11):e31437. doi: 10.7759/cureus.31437. PMID: 36523741; PMCID: PMC9746526.
9. Chobanian AV, Bakris GL, Black HR, Cushman WC, Green LA, Izzo JL Jr, Jones DW, Materson BJ, Oparil S, Wright JT Jr, Roccella EJ; National Heart, Lung, and Blood Institute Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure; National High Blood Pressure Education Program Coordinating Committee. The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure: the JNC 7 report. JAMA. 2003 May 21;289(19):2560-72. doi: 10.1001/jama.289.19.2560. Epub 2003 May 14. Erratum in: JAMA. 2003 Jul 9;290(2):197. PMID: 12748199.
10. James PA, Oparil S, Carter BL, Cushman WC, Dennison-Himmelfarb C, Handler J, Lackland DT, LeFevre ML, MacKenzie TD, Ogedegbe O, Smith SC Jr, Svetkey LP, Taler SJ, Townsend RR, Wright JT Jr, Narva AS, Ortiz E. 2014 evidence-based guideline for the management of high blood pressure in adults: report from the panel members appointed to the Eighth Joint National Committee (JNC 8). JAMA. 2014 Feb 5;311(5):507-20. doi: 10.1001/jama.2013.284427. Erratum in: JAMA. 2014 May 7;311(17):1809. PMID: 24352797.
11. Al-Makki A, DiPette D, Whelton PK, Murad MH, Mustafa RA, Acharya S, Beheiry HM, Champagne B, Connell K, Cooney MT, Ezeigwe N, Gaziano TA, Gidio A, Lopez-Jaramillo P, Khan UI, Kumarapeli V, Moran AE, Silwimba MM, Rayner B, Sukonthasan A, Yu J, Saraffzadegan N, Reddy KS, Khan T. Hypertension Pharmacological Treatment in Adults: A World Health Organization Guideline Executive Summary. Hypertension. 2022 Jan;79(1):293-301. doi: 10.1161/HYPERTENSIONAHA.121.18192. Epub 2021 Nov 15. PMID: 34775787; PMCID: PMC8654104.
12. Paz MA, de-La-Sierra A, Sáez M, Barceló MA, Rodríguez JJ, Castro S, Lagarón C, Garrido JM, Vera P, Coll-de-Tuero G. Treatment efficacy of anti-hypertensive drugs in monotherapy or combination: ATOM systematic review and meta-analysis of randomized clinical trials according to PRISMA statement. Medicine (Baltimore). 2016 Jul;95(30):e4071. doi: 10.1097/MD.0000000000004071. PMID: 27472680; PMCID: PMC5265817.
13. Ofori-Asenso R, Agyeman AA. Irrational Use of Medicines-A Summary of Key Concepts. Pharmacy (Basel). 2016 Oct 28;4(4):35. doi: 10.3390/pharmacy4040035. PMID: 28970408; PMCID: PMC5419375.
14. Garg M, Vishwakarma P, Sharma M, Nehra R, Saxena KK. The impact of irrational practices: A wake up call. J Pharmacol Pharmacother. 2014 Oct;5(4):245-7. doi: 10.4103/0976-500X.142434. PMID: 25422564; PMCID: PMC4231553.
15. Joshi R, Medhi B, Prakash A, Chandy S, Ranjalkar J, Bright HR, Basker J, Govindraj L, Chugh PK, Tripathi CD, Badyal DK, Balakrishnan S, Jhaj R, Shukla AK, Atal S, Najmi A, Banerjee A, Kamat S, Tripathi RK, Shetty YC, Parmar U, Rege N, Dikshit H, Mishra H, Roy SS, Chatterjee S, Hazra A, Bhattacharya M, Das D, Trivedi N, Shah P, Chauhan J, Desai C, Gandhi AM, Patel PP, Shah S, Sheth S, Raveendran R, Mathaiyan J, Manikandan S, Jeevitha G, Gupta P, Sarangi SC, Yadav HN, Singh S, Kaushal S, Arora S, Gupta K, Jain S, Cherian JJ, Chatterjee NS, Kaul R, Kshirsagar NA. Assessment of prescribing pattern of drugs and completeness of prescriptions as per the World Health Organization prescribing indicators in various Indian tertiary care centers: A multicentric study by Rational Use of Medicines Centers-Indian Council of Medical Research network under National Virtual Centre Clinical Pharmacology activity. Indian J Pharmacol. 2022 Sep-Oct;54(5):321-328. doi: 10.4103/ijp.ijp_976_21. PMID: 36537400; PMCID: PMC9846909.
16. Gama, Helena. (2007). Drug utilization studies. Arq Med. 22.
17. Wettermark, Bjorn & Elseviers, Monique & Almarsdóttir, Anna Birna & Andersen, Morten & Benko, Ria & Bennie, Marion & Eriksson, Irene & Godman, Brian & Krska, Janet & Poluzzi, Elisabetta & Taxis, Katja & Vander Stichele, Robert & Vlahovic-Palcevski, Vera. (2016). Introduction to drug utilization research. 10.1002/9781118949740.ch1.
18. Neville H, Trenaman SC. Drug Utilization Research: Methods and Applications. Can J Hosp Pharm. 2017 Jul-Aug;70(4):325. Epub 2017 Aug 31. PMCID: PMC5587052.
19. Nitya S, Ramya G, Kiruthika S, Meenakshi R, Devi JN, Suganya G, Pravin S. Drug utilization pattern and factors associated with polypharmacy and excessive polypharmacy in geriatric medical out-patients at a rural health training centre in India. J Family Med Prim Care. 2021 Jul;10(7):2636-2641. doi: 10.4103/jfmpc.jfmpc_2417_20. Epub 2021 Jul 30. PMID: 34568148; PMCID: PMC8415691.
20. Fuchs FD, Whelton PK. High Blood Pressure and Cardiovascular Disease. Hypertension. 2020 Feb;75(2):285-292. doi: 10.1161/HYPERTENSIONAHA.119.14240. Epub 2019 Dec 23. PMID: 31865786; PMCID: PMC10243231.
21. Kario, K., Okura, A., Hoshide, S. et al. The WHO Global report 2023 on hypertension warning the emerging hypertension burden in globe and its treatment strategy. Hypertens Res 47, 1099–1102 (2024). https://doi.org/10.1038/s41440-024-01622-w
22. Anchala R, Kannuri NK, Pant H, Khan H, Franco OH, Di Angelantonio E, Prabhakaran D. Hypertension in India: a systematic review and meta-analysis of prevalence, awareness, and control of hypertension. J Hypertens. 2014 Jun;32(6):1170-7. doi: 10.1097/HJH.0000000000000146. PMID: 24621804; PMCID: PMC4011565.
23. Giezendanner S, Tschudi P, Leuppi J, Dieterle T, Zeller A. Effect of guideline revisions by the Swiss Society of Hypertension on blood pressure control in hypertensive patients from primary care. Swiss Med Wkly. 2020 Jun 29;150:w20279. doi: 10.4414/smw.2020.20279. PMID: 32657419.
24. Satheesh G, Dhurjati R, Balagopalan JP, Mohanan PP, Salam A. Comparison of Indian clinical practice guidelines for the management of hypertension with the World Health Organization, International Society of Hypertension, American, and European guidelines. Indian Heart J. 2024 Jan-Feb;76(1):6-9. doi: 10.1016/j.ihj.2023.12.009. Epub 2024 Jan 1. PMID: 38171390; PMCID: PMC10943557.
25. Mukete BN, Ferdinand KC. Polypharmacy in Older Adults With Hypertension: A Comprehensive Review. J Clin Hypertens (Greenwich). 2016 Jan;18(1):10-8. doi: 10.1111/jch.12624. Epub 2015 Jul 27. PMID: 26215211; PMCID: PMC8031793.
26. Mohammad R, Bansod DW. Hypertension in India: a gender-based study of prevalence and associated risk factors. BMC Public Health. 2024 Oct 1;24(1):2681. doi: 10.1186/s12889-024-20097-5. PMID: 39354462; PMCID: PMC11443669.
27. Mohanty P, Patnaik L, Nayak G, Dutta A. Gender difference in prevalence of hypertension among Indians across various age-groups: a report from multiple nationally representative samples. BMC Public Health. 2022 Aug 10;22(1):1524. doi: 10.1186/s12889-022-13949-5. PMID: 35948916; PMCID: PMC9364494.
28. Alexander T, Hiremath JS, Swahney JPS, Chandra S, Jain P, Chandra P, Sinha N, Sashikanth T, Bachhu Y, Balachandran A, Jayagopal PB, Unni TG, Nair T, Kannan K, Prabhakar D, Chenniappan M, Mahajan AU, Karnik RD, Ponde CK, Advani P, Khan IA, Goyal BM, Vaidyanathan PR, Prajapati H, Verberk WJ. Identifying Drug Prescription in Newly Diagnosed Hypertension Patients in India. J Clin Hypertens (Greenwich). 2025 Jan;27(1):e14963. doi: 10.1111/jch.14963. PMID: 39822165; PMCID: PMC11771799.
29. Abdelkader NN, Awaisu A, Elewa H, El Hajj MS. Prescribing patterns of antihypertensive medications: A systematic review of literature between 2010 and 2020. Explor Res Clin Soc Pharm. 2023 Aug 5;11:100315. doi: 10.1016/j.rcsop.2023.100315. PMID: 37635839; PMCID: PMC10448163.
30. Jadhav U, Mohanan PP, Almeida AF, Abraham G, Khan MY, Gaurav K, Mane A, Vikas S, Jain M, Meel B. Effectiveness and Effect on Renal Parameters of Amlodipine vs. Other Dihydropyridine Calcium Channel Blockers in Patients with Essential Hypertension: Retrospective Observational Study Based on Real-World Evidence from Electronic Medical Records. Cardiol Ther. 2021 Dec;10(2):465-480. doi: 10.1007/s40119-021-00224-8. Epub 2021 Jun 11. PMID: 34115326; PMCID: PMC8555025.
31. Delara M, Murray L, Jafari B, Bahji A, Goodarzi Z, Kirkham J, Chowdhury M, Seitz DP. Prevalence and factors associated with polypharmacy: a systematic review and Meta-analysis. BMC Geriatr. 2022 Jul 19;22(1):601. doi: 10.1186/s12877-022-03279-x. Erratum in: BMC Geriatr. 2022 Sep 12;22(1):742. doi: 10.1186/s12877-022-03388-7. PMID: 35854209; PMCID: PMC9297624.
32. Takahashi T, Ono H, Ono Y, Ishimitsu T, Matsuoka H. Combination therapy with telmisartan and spironolactone alleviates L-NAME exacerbated nephrosclerosis with an increase in PPAR-gamma and decrease in TGF-beta(1). Int Heart J. 2007 Sep;48(5):637-47. doi: 10.1536/ihj.48.637. PMID: 17998773.
Article Sidebar
Published
Jun 20, 2025
Article Details
How to Cite
Fadil Salmani, Shaktibala Dutta, Dr. Jyotsna Sharma, & Dr. Srihari Dutta. (2025). STUDY OF PRESCRIPTION PATTERNS OF ANTIHYPERTENSIVE AGENTS IN TERTIARY CARE TEACHING HOSPITAL. Journal of Population Therapeutics and Clinical Pharmacology, 32(5), 1113-1124. https://doi.org/10.53555/n5rvs088
Section
Articles
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
All articles published in JPTCP are licensed under Copyright Creative Commons Attribution-NonCommercial 4.0 International License.
Author Biographies
Fadil Salmani
PhD Scholar, Santhosh deemed to be University
Shaktibala Dutta
Professor & Head, Department of Pharmacology, SGRRIM&HS, Dehradun
Dr. Jyotsna Sharma
Professor & Head, Department of Pharmacology, G.S. Medical College, Hapur
Dr. Srihari Dutta
Heath Specialist (Immunization Supply chain & Primary Health care) United Nations Children Emergency Fund, MENA, Amman
How to Cite
Fadil Salmani, Shaktibala Dutta, Dr. Jyotsna Sharma, & Dr. Srihari Dutta. (2025). STUDY OF PRESCRIPTION PATTERNS OF ANTIHYPERTENSIVE AGENTS IN TERTIARY CARE TEACHING HOSPITAL. Journal of Population Therapeutics and Clinical Pharmacology, 32(5), 1113-1124. https://doi.org/10.53555/n5rvs088