Publication:

Antihypertensive prescribing patterns in type 2 diabetes patients with hypertension: a cross-sectional study

Background The combination of type 2 diabetes mellitus (T2DM) and hypertension is associated with an increased risk for cardiovascular, renal and metabolic complications. Guidelines such as JNC 8, ADA, NICE advocate ACEIs, ARBs, CCBs and thiazide diuretics to be first-line antihypertensive drugs for diabetic patients based on evidence. Nevertheless, prescribing habits still differ among low-resource areas, one of which is Bangladesh. Objectives were to assess the prescribing pattern of antihypertensive drugs in hypertensive T2DM patients who come for treatment to tertiary hospitals in Bangladesh and also to evaluate the level of adherence with the international guideline-recommended therapies.

Methods A cross-sectional study was carried out from August 2021 to July 2022 in a total of 246 hypertensive T2DM patients who received treatment in the OPDs of Sir Salimullah medical college and Mitford hospital (SSMCH) and BIRDEM. Data was obtained with the help of pretested questionnaire and analyzed through SPSS version 23.

Results The average age of participants were 59.5±10.5 years, and 56% were women. Overweight and obesity were more than common (75.8% and 12.1%, respectively). Comorbidities were prevalent including chronic kidney disease (CKD) (37.6%), dyslipidaemia (33.1%) and ischemic heart disease (29.3%). The classes of β-blockers (23.2%) were the most commonly used, followed by ARBs (20.8%), CCBs (17.4%), diuretics (12.4%) and ACEI (9.7%). 42.4% of patients received combination therapy.

Conclusions Prescriptions were characterized by inadequate compliance to established international standard with high rate of prescription of the non-guideline-favored beta blockers over ACEIs, ARBs and thiazide diuretics. Promotion of evidence-based prescriptive practices is required to optimize cardiovascular and renal outcomes in diabetic hypertensives in Bangladesh.