PATTERN OF ANTIHYPERTENSIVE THERAPY AMONG DIABETIC HYPERTEN- SIVE PATIENTS IN ZEWDITU MEMORIAL HOSPITAL, ADDIS ABABA.

Abstract

Introduction: Diabetes mellitus is becoming a common chronic disease in both developed and developing nations and is associated with significant cardiovascular disease morbidity and mortality. The presence of hypertension in patients with diabetes mellitus doubles the risk of cardiovascular disease including coronary heart disease, congestive heart failure, ischemic and hemorrhagic stroke, renalfailure and peripheral arterial disease.

Objective: The aim of this study was to assess the pattern of antihypertensive drug therapy among diabetic hypertensive patients in Zewditu Memorial Hospital Diabetic Clinic in Addis Ababa.

Methods: This is a hospital based retrospective review of medical records of 382 diabetic-hypertensive patients who visited the Zewditu Memorial Hospital Diabetic Clinic in the period between August 2014 and January 2015.

Results: The most frequently prescribed antihypertensive drug classes were angiotensin converting enzyme inhibitor in 321 (84%) followed by calcium channel blocker in 229 (60%) and beta blocker in 145 (38%) patients. Enalapril, nifedipine, atenolol, losartan and hydrochlorthiazide were the only angiotensin converting enzyme inhibitor, calcium channel blocker, beta blocker, angiotensin receptor blocker and diuretic prescribed, respectively. Enalapril was used as a monotherapy in 73 (19%) and nifedipine in 26(7%), patients. The recommended target systolic blood pressure < 140 mmHg and diastolic blood pressure < 90 mmHg was achieved in only 57 (15%) patients while the remaining 325 (85%) did not attain the target blood pressure. Renal function was assessed in 351(92%) patients, of whom 23 (6%) had renal impairment with an estimated glomerular filtrate rate < 60 ml/min.

Conclusion: The pattern of antihypertensive drug therapy in our patients was consistent with the current treatment guidelines. However, the majority of diabetic-hypertensive patients did not reach target blood pressure.