10. Drug treatment for hypertension in a tertiary health care facility in northern Nigeria

This study investigated the prescription pattern of antihypertensive drugs, associated comorbid conditions and patients adherence to treatment plan. Randomly selected records of 200 patients attending the hypertension clinic of a Nigerian teaching Hospital were studied. Information on antihypertensive prescription, blood pressure control and adherence to treatment plan were evaluated. Sixty percent of the patients were males with an average age of 50.6years (SD=13.7). 91.5% of the patients were on antihypertensive drug combinations with 85 (42.5%), 61(30.5%), 34(17.0%), 2(1%) and 1(0.5%) patients on combination of two, three, four, five, and six drugs respectively. Diuretics were the most commonly prescribed antihypertensive drug class in 88% of all prescriptions. This is followed by angiotensin converting enzyme inhibitors (62%), calcium channel blockers (59%), centrally acting drugs (15.5%) and beta blockers (14.5%). Diabetes mellitus and hyperlipidemia were the most common comorbid conditions (13% and 9.5%). The BP control rate was 34.5% and 23.1% in all patients and those with diabetes respectively. Only 53% of patients were adherent to treatment plan. There was significant difference in control rates between patients on combination therapy compared to those on monotherapy (p<0.05). Instructions on lifestyle modifications were poorly documented. Combination therapy was offered to over 90% of patients in this study while diuretics, ACE inhibitors and calcium channel blockers were the most commonly prescribed drugs. Adherence to therapy was poor and blood pressure control rates remained unsatisfactory. There is need for sustained education on lifestyle modification and adherence to therapy as a means of improving blood pressure control rates in this environment