Prescription of pharmacotherapy and blood pressure control among hypertensive outpatients in two semi-urban hospitals in Cameroon: a cross-sectional study.

INTRODUCTION

several international guidelines are available on drug treatment for hypertension, but the control of hypertension remains very poor in sub-Saharan Africa (SSA). We investigated the commonly prescribed antihypertensive drugs and their association with blood pressure (BP) control in adult Cameroonians.

METHODS

we consecutively recruited hypertensive outpatients attending the Buea and Limbe Regional Hospitals (southwest region of Cameroon). Controlled BP was defined as BP < 140/90mmHg in hypertensive patients aged 60 years or younger, diabetics or patients with chronic kidney disease or a BP < 150/90mmHg in non-diabetic hypertensive patients older than 60 years of age (JNC8).

RESULTS

of the 408 participants included (mean age 61.1 years), 67% were female. The median duration of hypertension was 6 years and the median duration of the current treatment was 22 weeks. Commonly prescribed antihypertensives were calcium channel blockers (CCB, 35.1%), thiazide/thiazide-like diuretics (TD/TLD, 26.1%) and angiotensin-converting enzyme inhibitors (ACEI, 19.5%). The median monthly cost of antihypertensive was 10279.6 CFA (approximately equal to US$ 172). Seventy percent (70%) of participants were receiving at least 2 drugs, with ACEI+TD/TLD, CCB+TD/TLD, and ACEI+CCB+TD/TLD being the most frequent combination. The rate of BP control was 52% overall, and 60% in participants on monotherapy.

CONCLUSION

CCBs were the most prescribed single antihypertensive drugs in this setting while ACEI+TD/TLD was the most common combination. About half of patients were at target BP control levels Improving availability and affordability of these medications may improve hypertension management and control.