Antihypertensive use, prescription patterns, and cost of medications in a Teaching Hospital in Lagos, Nigeria

Abstract

Introduction: Hypertension has been reported as the strongest modifiable risk factor for cardiovascular morbidity and mortality.

Aims: The aim of the study was to identify the most prescribed antihypertensive drugs, its patterns, comorbidities, cost of medications, and laboratory investigations.

Settings and Design: This study was a cross‑sectional, descriptive study of hypertensive patients conducted at the Lagos State University Teaching Hospital, Ikeja.

Subjects and Methods: A total of 200 case notes were retrieved from the medical records unit over a period of 8 weeks. Information on antihypertensive prescriptions and comorbidities was retrieved. The average cost of medications and laboratory investigations was calculated.

Statistical Analysis Tool Used: SPSS software version 16.

Results: The mean age of the patients was 58.44 ± 12.65 years. Of the 200 patients, 5 (2.5%) were on monotherapy and 195 (97.5%) were on combination therapy. One hundred and twenty (60%) patients had comorbidities which included congestive heart failure 55 (27.5%), diabetes mellitus 22 (11%), hyperlipidemia 15 (7.5%), and cardiovascular disease 13 (6.5%). The various classes of antihypertensive drugs prescribed were diuretics 128 (64.0%), beta‑blockers 126 (63.0%), calcium channel blockers 106 (53.0%), angiotensin‑converting enzymes inhibitors 103 (51.5%), angiotensin receptor blockers 33 (16.5%), alpha blockers 9 (4.5%), and fixed drug combinations 2 (1.0%). The average cost per month of the antihypertensive medications was ₦ 2045 (US$10.2).

Conclusions: Antihypertensive prescription pattern was in accordance with the seventh report of Joint National Committee on Prevention, Detection, Evaluation, and Treatment of high blood pressure. Community‑based insurance scheme should be encouraged and effective implementation of integrated noncommunicable diseases screening into the primary health care services would be helpful.

Keywords: Antihypertensive drugs, comorbidities, costs, prescription patterns