Olanrewaju T O, Aderibigbe A, Busari O A, Sanya E O
Division of Nephrology, Department of Medicine, University of Ilorin Teaching Hospital, PMB 1459, Ilorin, Nigeria.
Int J Clin Pharmacol Ther. 2010 Jan;48(1):68-75. doi: 10.5414/cpp48068.
Despite availability and usage of wide array of antihypertensive drugs, blood pressure has remained poorly controlled in most health care settings particularly in Africa. The cost of these drugs among other factors strongly determines the prescription and usage pattern which ultimately affects control of blood pressure particularly in sub-Saharan Africa. The aim of this study was to describe the current utilization pattern of antihypertensive drugs in a tertiary hospital in Nigeria in line with the regional and international guidelines for hypertension management and to compare with similar studies in other parts of the country to generate the national outlook.
This is a cross sectional study of 805 adult hypertensive patients who were on treatment at the Medical Out-Patient Department of University of Ilorin Teaching Hospital in Nigeria, a country with the most populous black hypertensive patients. Data were collated from the patients' records and evaluated according to drug classifications.
787 patients out of the 805 evaluated were eventually included in the analysis. Mean age was 57.88 + or - 12.59 years with 490 (62.3%) females. Frequency of use of classes of antihypertensive was: diuretics (D, 84%), calcium channel blockers (CCB, 66%), angiotensin converting enzyme inhibitors (ACEI, 65%), a-methyldopa (ALD, 26%), beta-blockers (BB, 11.9%) and angiotensin receptor blockers (3.8%). Proportions of number of drugs usage per patient were: 0 (2.2%), 1 (9.1%), 2 (37.1%), 3 (35.8%), 4 (15.6%), and 5 (0.1%). The most commonly used combinations of drugs were ACEI + CCB + D (21.6%), followed by CCB + D (14.5%), ACE + D (11.4%) and ACEI + D + ALD (9.8%). Other recent studies in Nigeria revealed diuretics and multiple agents as the prevalent prescription pattern.
Antihypertensive utilization in Ilorin, Nigeria like some parts of the country conforms to the guidelines for the management of hypertension in blacks with majority of patients on diuretics particularly in combination with other agents. Angiotensin converting enzyme inhibitors are increasingly being used whereas beta-blockers and angiotensin receptor antagonists are still less utilized.
尽管有多种抗高血压药物可供使用且被广泛应用，但在大多数医疗机构中，血压控制情况仍然很差，特别是在非洲。这些药物的成本以及其他因素在很大程度上决定了处方和使用模式，这最终影响了血压控制情况，尤其是在撒哈拉以南非洲地区。本研究的目的是根据高血压管理的区域和国际指南，描述尼日利亚一家三级医院目前抗高血压药物的使用模式，并与该国其他地区的类似研究进行比较，以得出全国的情况。
这是一项对805名成年高血压患者的横断面研究，这些患者在尼日利亚伊洛林大学教学医院门诊部接受治疗，该国是黑人高血压患者人口最多的国家。数据从患者记录中整理出来，并根据药物分类进行评估。
805名接受评估的患者中，787名最终被纳入分析。平均年龄为57.88±12.59岁，其中490名（62.3%）为女性。抗高血压药物类别的使用频率为：利尿剂（D，84%）、钙通道阻滞剂（CCB，66%）、血管紧张素转换酶抑制剂（ACEI，65%）、α-甲基多巴（ALD，26%）、β-阻滞剂（BB，11.9%）和血管紧张素受体阻滞剂（3.8%）。每位患者使用药物数量的比例为：0种（2.2%）、1种（9.1%）、2种（37.1%）、3种（35.8%）、4种（15.6%）和5种（0.1%）。最常用的药物组合是ACEI+CCB+D（21.6%），其次是CCB+D（14.5%）、ACE+D（11.4%）和ACEI+D+ALD（9.8%）。尼日利亚最近的其他研究表明，利尿剂和多种药物是普遍的处方模式。
尼日利亚伊洛林的抗高血压药物使用情况与该国一些地区一样，符合黑人高血压管理指南，大多数患者使用利尿剂，特别是与其他药物联合使用。血管紧张素转换酶抑制剂的使用越来越多，而β-阻滞剂和血管紧张素受体拮抗剂的使用仍然较少。
