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Utilization pattern of antihypertensive drugs in Chinese diabetics

Purpose: To assess blood pressure control and to evaluate and compare the utilization pattern of antihypertensive therapies in Chinese patients with diabetes.

Design: Cross-sectional study.

Setting: Tertiary care centre.

Methods: Prescription/drug usage and clinical data were collected from medical records of patients with coexistent uncomplicated hypertension and type-2 diabetes from July 2014 to August 2015. Univariate analysis with Chi-square and t- test was performed followed by logistic regression to evaluate independent predictors.

Results: Out of 1166 diabetics, 968 (83%) had coexistent hypertension (57.75% men; 42.25% women). In total, controlled blood pressure was noted in 337 (34.81%) patients (18.9% isolated systolic hypertension, 4.44% isolated diastolic hypertension, and 41.83% both). Nearly 42.98% patients were on monotherapy and 57.02% on polytherapy. Overall, calcium channel blockers (CCBs) were prescribed mostly (58.47%) (monotherapy or polytherapy), secondly angiotensin receptor blockers (ARBs) (45.45%) and then angiotensin converting enzyme inhibitors (ACEIs) (25.93%), diuretics (DIs) (24.9%) and beta-blockers (BBs) (18.9%).

Conclusion: The majority of diabetic outpatients with hypertension received polytherapy achieving BP target in accordance with recommendations. The most often used antihypertensives were CCBs, followed by ARBs, ACEIs, BBs and DIs, suggesting the non-optimized treatment of hypertension. Continued efforts are needed in order to improve antihypertensive drug usage.

Author(s): Li-jun Song, Li-zheng Fang, Jian-hua Chen