Back to Search
Start Over
Prescribing Patterns and Therapeutic Implications for Diabetic Hypertension in Bahrain
- Source :
- Annals of Pharmacotherapy. 35:1350-1359
- Publication Year :
- 2001
- Publisher :
- SAGE Publications, 2001.
-
Abstract
- OBJECTIVE: To determine drug prescription patterns and the extent of conformity with World Health Organization/International Society of Hypertension (WHO/ISH) guidelines in diabetic hypertension. DESIGN: Retrospective prescription-based survey. SETTING: Seven primary-care health centers, comprising approximately one-third of primary-care health centers in Bahrain. PATIENTS: Patients with type 2 diabetes and hypertension. MAIN OUTCOME MEASURE: The prescribing pattern of antihypertensive and antidiabetic drugs. RESULTS: Among a study sample of 1463 patients with type 2 diabetes and hypertension, antidiabetic agents were prescribed as monotherapy in the following descending order: glyburide, gliclazide, insulin, and metformin. As combinations, sulfonylureas plus metformin was most popular, followed by metformin plus insulin, and sulfonylureas plus insulin. Sulfonylurea and metformin with insulin was rarely used. There was no significant difference in prescribing of glyburide and metformin between the elderly and young middle-aged diabetic patients; many patients older than 65 years were treated with a β-blocker along with a long-acting sulfonylurea. Both as monotherapy and in overall use, β-blockers, angiotensin-converting enzyme (ACE) inhibitors, and calcium-channel blockers were most often prescribed. Among 35.5% patients treated with antihypertensive combinations, various two- and three-drug combinations of β-blockers, ACE inhibitors, calcium-channel blockers, and diuretics were often used. The proportion of patients taking atenolol 100 mg/d was higher with combination regimens. Hydrochlorothiazide 25 mg or equivalent thiazide diuretics were extensively used. CONCLUSIONS: The prescribing pattern of antihypertensives in diabetic hypertension differs in many instances from WHO/ISH guidelines, especially regarding the choice of antihypertensive drugs and their combinations. The appropriateness of antidiabetic drug choice is questionable in relation to the antihypertensive used.
- Subjects :
- medicine.medical_specialty
medicine.drug_class
Sodium Chloride Symporter Inhibitors
medicine.medical_treatment
Adrenergic beta-Antagonists
Angiotensin-Converting Enzyme Inhibitors
Type 2 diabetes
Benzothiadiazines
Drug Prescriptions
030226 pharmacology & pharmacy
Diabetes Complications
03 medical and health sciences
Drug Utilization Review
0302 clinical medicine
Diabetes mellitus
Internal medicine
medicine
Humans
Hypoglycemic Agents
Insulin
Pharmacology (medical)
Gliclazide
030212 general & internal medicine
Medical prescription
Diuretics
Antihypertensive Agents
Retrospective Studies
business.industry
Age Factors
Retrospective cohort study
medicine.disease
Sulfonylurea
Metformin
Drug Combinations
Endocrinology
Bahrain
Hypertension
business
medicine.drug
Subjects
Details
- ISSN :
- 15426270 and 10600280
- Volume :
- 35
- Database :
- OpenAIRE
- Journal :
- Annals of Pharmacotherapy
- Accession number :
- edsair.doi.dedup.....0b8a3083a7876b027093296267c9fa73