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. 2017 Nov-Dec;49(6):438-444.
doi: 10.4103/ijp.IJP_590_17.

Switching of antihypertensive drugs at Tertiary Care Government Hospital, Hyderabad, India: A cross-sectional retrospective investigation

Varsha Varakantham  1 , Ashok Kumar Kurakula Sailoo  2 , Venkaiah Kodali  3 , Dinesh Kumar Bharatraj  1
Affiliations

Switching of antihypertensive drugs at Tertiary Care Government Hospital, Hyderabad, India: A cross-sectional retrospective investigation

Varsha Varakantham et al. Indian J Pharmacol. 2017 Nov-Dec.

Abstract

Objective: Switching of antihypertensive drugs is attributed to uncontrolled blood pressure (BP) which imposes a great burden on health economics. But again, switching leads to accomplishment of the goal BP, thereby improving the health status. Such studies are well documented in developed nations but rarely reported in developing countries, especially in India. Therefore, the aim of this study was to evaluate various factors associated with switching of antihypertensive drugs.

Methods: A cross-sectional retrospective investigation was performed using a standardized schedule adapting the World Health Organization indicators for drug utilization in a tertiary care government hospital, Hyderabad, India. A total of 429 prescriptions were monitored for a switchover to a different antihypertensive drug in 180 days.

Results: The results revealed that the duration of hypertension (HTN) >5-10 years (adjusted odds ratio [aOR] = 3.73, P < 0.05), two or more symptoms of HTN (aOR = 3.42, P < 0.05), 2014 prescriptions (aOR = 4.54, P < 0.001), polytherapy (aOR = 2.85, P < 0.001), noncompliance to National List of Essential Medicine (NLEM) (aOR = 1.631, P < 0.05), and systolic BP (SBP) (aOR = 1.77, P < 0.05) were the predictors, which were highly likely to switch (38.5%) the antihypertensive drugs. Diuretics (0.7%) were poorly prescribed, the first line of therapy suggested by Seventh Joint National Committee (JNC VII). Stepwise logistic regression analysis revealed, the calendar year 2014 (odds ratio [OR] = 3.23, P < 0.001), polytherapy (OR = 2.5, P < 0.001), and the level of SBP ≥140 mmHg (OR = 1.82, P < 0.01) as the three major predictors which showed a likelihood of switching medication.

Conclusions: Findings of the study reveals predictors of the switchover like uncontrolled SBP, duration of HTN, compliance with the list of NLEM drugs, polytherapy, enabling the clinicians to critically analyze the patients' profile, and hence, reach target BP soon, i.e., decreased cardiovascular risk.

Keywords: Antihypertensive drugs; India; retrospective study; switchover.

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Conflict of interest statement

There are no conflicts of interest.

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References

    1. Krishnan MN, Zachariah G, Venugopal K, Mohanan PP, Harikrishnan S, Sanjay G, et al. Prevalence of coronary artery disease and its risk factors in Kerala, South India: A community-based cross-sectional study. BMC Cardiovasc Disord. 2016;16:1–12. - PMC - PubMed
    1. World Health Organization. Global Status Report on Noncommunicable Diseases. 2010. [Last accessed on 2017 Aug 21]. Available from: http://www.who.int/nmh/publications/ncd_report2010/en/index.html .
    1. Go AS, Mozaffarian D, Roger VL, Benjamin EJ, Berry JD, Borden WB, et al. Executive summary: Heart disease and stroke statistics-2013 update: A report from the American Heart Association. Circulation. 2013;127:143–52. - PubMed
    1. Anchala R, Kannuri NK, Pant H, Khan H, Franco OH, Di Angelantonio E, et al. Hypertension in India: A systematic review and meta-analysis of prevalence, awareness, and control of hypertension. J Hypertens. 2014;32:1170–7. - PMC - PubMed
    1. Ambrosioni E, Leonetti G, Pessina AC, Rappelli A, Trimarco B, Zanchetti A, et al. Patterns of hypertension management in Italy: Results of a pharmacoepidemiological survey on antihypertensive therapy. Scientific Committee of the Italian Pharmacoepidemiological Survey on Antihypertensive Therapy. J Hypertens. 2000;18:1691–9. - PubMed

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