Patterns of antihypertensive agents use in 11,947 Colombian patients.

Abstract

In Colombian populations older than 15 years, 12.6% suffer from hypertensive disease. Pharmacological therapies for hypertension and associated diseases were compared for 11,947 adult hypertensive patients of both sexes. All had been in treatment for more than 3 months (November/01-January/02), and were distributed among six Colombian cities. The data were retrieved from medication consumption registers that were maintained by the institutions that distribute medications to patients selected for the study. The average age of patients was 55.8 +/- 13.8, and 67.7% were women. Men were older (p < 0.05) and consumed other drugs more than women (67.7% vs. 62.4%, p < 0.05); 53.2% of patients received only one drug and 46.8% received between 2 to 5 drugs for hypertension disease. Medications most commonly prescribed were hydrchlorothiazide (31.8%), captopril (27.9%), verapamil (27.6%), enalapril (25%), metoprolol (15.1%) and propranolol (14.9%). The most common combinations were hydrochlorothiazide + ACE inhibitors (n = 2,001), hydrochlorothiazide + calcium channel antagonists (n = 1,367), verapamil + ACE inhibitors (n = 1,153) and hydrochlorothiazide + beta blocker (n = 1,021). Other prescribed medications included ASA as antiplatelet (38.2% of patients), nonsteroidal anti-inflammatory drugs (NSAID, 16.2%), lipid-lowering drugs (11.8%), hypoglycemic agents (10.9%) and antiulcerous drugs (9.6%). Some agents are probably underemployed (ACE inhibitors, ASA) and others overused (antiulcerous). Potentially dangerous pharmacological interactions were discovered in 410 cases (3.43%). Significant differences occurred in physicians' formulations among the six cities, but rational prescription patterns prevailed. Newly designed educational strategies are recommended to prevent administration of potential harmful combinations. Further exploration of clinical results in these formulations is indicated.