Evaluating the Prescribing Patterns of Antihypertensive Medications in a Student-Run Free Clinic

Background: Hypertension is one of the most widespread disease states and a high-risk factor for developing other cardiovascular diseases such as stroke and coronary disease. In the uninsured population, uncontrolled blood pressure is primarily due to limited access to healthcare. While there has been a review to assess the quality of hypertension management provided at the Building Relationships and Initiatives Dedicated to Gaining Equality (BRIDGE) Clinic, this study will evaluate the prescribing patterns of antihypertensives at the clinic and assess whether the clinic is adhering to current treatment guidelines. Methods: A retrospective chart review was performed for BRIDGE patients 18 years and older that were diagnosed with hypertension between 2012 and 2021. The drug classes studied included thiazide diuretics, calcium channel blockers (CCBs), angiotensin-converting-enzyme inhibitors (ACEI), and angiotensin receptor blockers (ARBs). The initial and maintenance doses were compared to Food and Drug Administration (FDA)-recommended dosing to determine if the appropriate doses were prescribed. Results: A total of 123 patient charts were reviewed. 54.7% of patients with Stage 1 hypertension were initially started on only one medication. For Stage 1 maintenance, 47.3% of the patients were continued on only one medication. In patients with Stage 2, 45.8 % were initially started on a combination of 2 or more medications. For Stage 2 maintenance, 79.2% of the patients were continued on a combination of 2 or more medications. Patients with Stage 1 had prescribing patterns that did not adhere to guidelines while most Stage 2 patients adhered to guidelines. Conclusions: The results suggest that the BRIDGE Healthcare Clinic may be prescribing antihypertensive medications that do not entirely follow the prescribing patterns recommended by the Joint National Committee (JNC) 8 guidelines, which may impact effective treatment outcomes.