ANTIHYPERTENSIVE DRUGS USED BY HYPERTENSIVE PATIENTS IN THE PROVINCIAL CITIES OF ISFAHAN, NAJAFABAD an‎d ARAK

INTRODUCTION: Hypertension is the most prevalent chronic disease encountered by physicians. Its prevalence has been reported at 18% in Isfahan province. Hypertension control decreases the risk of stroke and coronary events by 50% and 15%, respectively. According to the World Health Organization (WHO), the rate of blood pressure control stands at 12.5%. Effective hypertension control requires measures such as screening, diagnosis, lifestyle improvement, and drug therapy. The type of drug regimen prescribed to the hypertensive patient is of key importance in achieving optimal control. The present study was performed to determine the type of drugs used by hypertensive patients in urban and rural areas of the provincial cities of Isfahan, Najaf-Abad and Arak. METHODS: This descriptive cross-sectional study was performed in the provincial cities of Isfahan, Najaf-Abad and Arak in 2000-2001, as part of Isfahan Healthy Heart Program (IHHP). Cluster sampling method was used to select 10674 individuals from the urban and rural areas of the said provincial cities. The patients had systolic blood pressure greater than 140 mmHg, or diastolic blood pressure greater than 90 mmHg or both, or received antihypertensive medications. Data were entered into the EPI-5 software and analyzed with t-test using SPSS. RESULTS: A total of 2015 hypertensive individuals (18.9%) were identified. Awareness of being hypertensive and rate of treatment and control of hypertension measured 47%, 23% and 9% respectively. Of 670 patients under treatment, 527 had been treated with one drug type, 133 with two drug types with 35 different combinations, and 30 used three drug types with 25 different combinations. Among single-drug regimens, beta-blockers were the most common choice (23%) and atenolol and methyldopa were the most frequently prescribed drugs, respectively. The frequency of diuretics use was 0.9%. Inappropriate combinations such as atenolol plus propranolol were seen among two- and three-drug regimens (nine patients). DISCUSSION: Drug regimens used by many hypertensive patients are not consistent with standard protocols; these regimens are ineffective in blood pressure control and lead to increased side-effects and subsequently patient noncompliance. Thus, further education of physicians and other healthcare providers on hypertension and antihypertensive treatment seems essential.