Analysis of the current status of antihypertensive drug use at the outpatient hypertention clinic, Van Giang district health center, Hung Yen province, in 2024

Abstract

Objective: To describe the current situation and analyze the rationality of antihypertensive drug use in patients at the outpatient hypertension clinic of Van Giang District Health Center, Hung Yen Province, in 2024. Methods: A retrospective cross-sectional study was conducted using data from 400 patient medical records at the hypertension clinic from April 1, 2024, to July 31, 2024. Patients included were over 18 years old, had continuous follow-up during the 4-month period, underwent clinical and laboratory monitoring (including mandatory serum creatinine), and had complete blood pressure records throughout the follow-up period. Results: The average age of the study sample was 69,12 ± 9,15 years, with a higher proportion of female patients compared to male patients (52% vs 48%). Among the patients, 89% had hypertension with dyslipidemia, and 61% had angina. Diuretics were the most commonly prescribed drugs (66,69%), followed by angiotensin II receptor blockers (61,69%). A total of 36 different treatment regimens were used; the combination of ARB + diuretic was the most common (38,19%). Most patients achieved target blood pressure, with no significant difference across the 4-month follow-up period. Among hypertensive patients without specific comorbidities, 85,35% received appropriate prescriptions. However, only 16,15% of those with hypertension and angina received appropriate prescriptions. Perindopril was the drug most frequently prescribed inappropriately with respect to renal function, accounting for 41,7% of the 120 prescriptions involving this drug. There were 95 prescriptions with serious drug interactions between ACE inhibitors and ARBs. There are four contraindicated combinations in patients with a creatinine clearance (ClCr) < 30 mL/min: Irbesartan + Hydrochlorothiazide, Telmisartan + Hydrochlorothiazide, Losartan + Hydrochlorothiazide, and Candesartan + Hydrochlorothiazide. Conclusion:  The majority of patients at the Hypertension Clinic of Van Giang District Health Center achieved target blood pressure levels; however, physicians’ prescribing practices remain suboptimal in terms of drug selection and dosing, instances of drug interactions and prescriptions given despite contraindications were also observed.