Related Experiment Videos
[Prescription patterns of antihypertensive agents in general practice in 1995]
H P Stokke1, T Klemetsrud, A Westheim
1Hjertemedisinsk avdeling Ullevål sykehus, Oslo.
Insights
This study found that many antihypertensive drugs lacking proven benefits for cardiovascular outcomes were frequently prescribed in general practice. While most prescriptions aligned with guidelines, elderly patients were underprescribed diuretics.
Area of Science:
- Cardiology
- General Practice
- Pharmacotherapy
Context:
- Hypertension is a significant risk factor for cardiovascular disease.
- Effective management of hypertension is crucial for public health.
- Antihypertensive drug prescription patterns in general practice warrant investigation.
Purpose:
- To analyze the prescription patterns of antihypertensive drugs in Norwegian general practice.
- To assess daily dosages and drug combinations used in hypertension management.
- To compare prescription practices with established clinical guidelines.
Summary:
- A survey of 2,586 hypertensive patients revealed that 63% were on monotherapy.
- Commonly prescribed drug classes included beta-blockers, calcium channel blockers, and diuretics.
- Notably, antihypertensives without documented effects on morbidity and mortality were frequently prescribed.
Impact:
- Highlights potential areas for optimizing hypertension treatment in primary care.
- Suggests a need to re-evaluate the use of certain antihypertensives based on evidence.
- Identifies a discrepancy in diuretic use among elderly patients compared to guidelines.
Background:
Hypertension represents a risk factor in the development of cardiovascular disease.
Material And Methods:
The prescription of antihypertensive drugs and the daily doses used were examined in a questionnaire-based survey among 2,586 drug-treated hypertensive patients who attended a general practitioner for clinical control in November 1995.
Results:
The proportion of patients treated with one antihypertensive drug only was 63%. ACE inhibitors, alpha blockers and angiotensin-II antagonists constituted 22.7%, 6.6% and 4.4%, and betablockers, calcium channel blockers and diuretics 21.7%, 23.7% and 16.3% of the prescriptions respectively. Women were more often prescribed diuretics than men, and older individuals more often than younger persons. No striking difference in the prescription of antihypertensive drugs were observed between the five health regions of Norway. There was no reduction in the prescribed daily doses of antihypertensives used in combination therapy compared with monotherapy. In approximately one quarter of the prescriptions there was a positive correlation between the prescribed daily dose and the patient's weight. The number of antihypertensives prescribed did positively correlate with the patient's weight.
Interpretation:
This survey shows that antihypertensives without any documented effect on morbidity and mortality were frequently prescribed for hypertension in general practice. Except for the low proportion of diuretic users among elderly patients, our results is in accordance with the Guidelines from the Norwegian Society of General Practitioners.