From guidelines to practice: antihypertensive prescribing preferences in Türkiye-the APP-Türkiye study

Antihypertensive prescribing patterns vary across countries, potentially influencing BP control rates, which remain suboptimal worldwide. To date, no study has evaluated national antihypertensive prescription distributions in Türkiye. This study aimed to investigate antihypertensive prescription preferences using nationwide health data. Data on age and sex were obtained for patients diagnosed with hypertension (HT) based on International Classification of Diseases-10 (ICD-10) codes and who were prescribed at least one antihypertensive drug between January 1, 2023, and January 1, 2024. Comorbidities were also identified using ICD-10 codes. Antihypertensive treatments were classified according to the Anatomical Therapeutic Chemical system. This study investigated the antihypertensive prescriptions of 10 705 115 individuals aged over 18. A total of 19 869 235 antihypertensives were prescribed over the one-year study period, with a mean number of 2.67 ± 1.53 per patient. The three most frequently prescribed antihypertensive groups in the general population were angiotensin-converting enzyme inhibitors, angiotensin receptor blockers and their combinations, and beta blockers (BBs). Although the top three antihypertensive agents used across all age groups were similar to those in the general population, an increase in the prescription of BBs, diuretics, and calcium channel blockers was observed with advancing age. Antihypertensive preferences in cases with comorbid diseases were consistent with current guidelines, and the use of single-pill combinations was higher than that of monotherapy, at 54.96%. In the light of the national data, it may be concluded that Turkish physicians generally adhere to current hypertension guideline recommendations in their antihypertensive prescription preferences.