Eshiet Unyime I, Yusuff Kazeem B
Department of Clinical Pharmacy & Pharmacy Administration, Faculty of Pharmacy, University of Ibadan. Ibadan ( Nigeria ).
Department of Clinical Pharmacy & Pharmacy Administration, Faculty of Pharmacy, University of Ibadan & Department of Pharmacy Practice, College of Clinical Pharmacy, King Faisal University. Hofuf Al-Ahsa, ( Saudi Arabia ).
Pharm Pract (Granada). 2014 Apr;12(2):419. doi: 10.4321/s1886-36552014000200009. Epub 2014 Mar 15.
Previous studies of anti-hypertensive medicines utilization pattern in Nigeria showed that Angiotensin converting enzyme inhibitors (ACEIs) were often the least prescribed. However, the appropriate use of ACEIs in the black population achieves good blood pressure control and provides additional long term cardio- and renovascular protection benefits.
To assess the current utilization pattern of antihypertensive medicines with specific emphasis on identifying possible shift in the frequency of use of ACEIs.
A prospective cross-sectional assessment of the current utilization pattern of anti-hypertensive medicines was conducted among 300 randomly selected cohort at a 900-bed premier Teaching Hospital located in Ibadan, Southwestern Nigeria. The current utilization pattern was compared with the results of a study conducted at the same site and published 10 years ago.
Of the 300 random cohorts, a majority (79%) were females (237) with mean age 58.7 years (SD=2.81 years. Stage 2 hypertension was the most frequent diagnosis (54.3%). The utilization of ACEIs and long acting CCB (amlodipine) significantly increased from 8.6% and 21% (Ten years ago) to 29.93% and 36.68% respectively (p < 0.0001). The use of thiazide diuretic and methyldopa declined significantly from 39.4% and 23.3% (Ten years ago) to 16.12% and 9.7% respectively (p < 0.0001). Adverse drug reactions due to ACEIs were documented in 1.5% (3), while laboratory monitoring of serum potassium, urea and creatinine was conducted in only 37% (111) of cohort. Potentially harmful drug-drug interactions were identified in 25% (75) of cohorts, and the most frequent were ACEIs + NSAIDs (53.3%), ACEIs + amiloride / hydrochlorothiazide (22.6%).
Anti-hypertensive medicines utilization has significantly shifted towards the increased use of ACEIs and long acting dihydropyridine CCBs. The use of thiazides and methyldopa has declined significantly. Physicians appeared more cognizant of the long term cardio- and renovascular benefits inherent in using ACEIs in a high cardiovascular risk group such as black hypertensive.
此前针对尼日利亚抗高血压药物使用模式的研究表明，血管紧张素转换酶抑制剂（ACEIs）的处方量通常是最少的。然而，在黑人人群中合理使用ACEIs可有效控制血压，并提供额外的长期心脏和血管保护益处。
评估抗高血压药物的当前使用模式，特别关注确定ACEIs使用频率的可能变化。
在尼日利亚西南部伊巴丹一家拥有900张床位的大型教学医院，对300名随机选取的队列进行了抗高血压药物当前使用模式的前瞻性横断面评估。将当前的使用模式与10年前在同一地点进行并发表的一项研究结果进行比较。
在300个随机队列中，大多数（79%）为女性（237人），平均年龄58.7岁（标准差=2.81岁）。2期高血压是最常见的诊断（54.3%）。ACEIs和长效CCB（氨氯地平）的使用比例从10年前的8.6%和21%显著增加至29.93%和36.68%（p<0.0001）。噻嗪类利尿剂和甲基多巴的使用比例从10年前的39.4%和23.3%显著下降至16.12%和9.7%（p<0.0001）。有1.5%（3人）记录了因ACEIs导致的药物不良反应，而仅37%（111人）的队列进行了血清钾、尿素和肌酐的实验室监测。25%（75人）的队列中发现了潜在有害的药物相互作用，最常见的是ACEIs+非甾体抗炎药（53.3%）、ACEIs+阿米洛利/氢氯噻嗪（22.6%）。
抗高血压药物的使用已显著转向增加ACEIs和长效二氢吡啶类CCB的使用。噻嗪类药物和甲基多巴的使用显著下降。医生似乎更清楚在黑人高血压患者等高心血管风险群体中使用ACEIs所固有的长期心脏和血管益处。
