Patterns of Antihypertensive Therapy in Diabetic Patients with and Without Reduced Renal Function

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Journal Title, Volume, Page: 
Saudi J Kidney Dis Transpl. 2010 Jul;21(4):652-9
Year of Publication: 
2010
Authors: 
Sawalha AF
Poison Control And Drug Information Center (PCDIC), An-Najah National University. Nablus, Palestine
Current Affiliation: 
Faculty of Medicine & Health Sciences, Department of Biomedical Sciences, An-Najah National University, Nablus, Palestine
Sweileh WM
College Of Pharmacy, An-Najah National University, Nablus, Palestine
Zyoud SH
Poison Control And Drug Information Center (PCDIC), An-Najah National University. Nablus, Palestine
Al-Jabi SW
College of Pharmacy, Clinical Pharmacy Graduate Program, Nablus, Palestine
Tameem EJ
Ministry of Health, Palestinian National Authority, Jenin, Palestine
Preferred Abstract (Original): 

Renal function deterioration is a common complication in patients with diabetes mellitus and hypertension. Appropriate use of anti-hypertensive agents and tight control of Blood Pressure (BP) can minimize and delay such complications. This study was performed in order to investigate the utilization patterns of anti-hypertensive agents and to evaluate BP control among diabetic-hypertensive patients with and without reduced renal function. In a retrospective cohort study, all diabetic­hypertensive patients attending The Al-Watani Medical Governmental Center from August 01, 2006 until August 01, 2007 were enrolled in the study. Patients with congestive heart failure and/or end­stage renal disease were excluded from the study. The proportion of use of five different anti­hypertensive drug classes were compared for all patients receiving 1, 2, 3, or 4 drugs, and separately among patients with and without reduced renal function. Over 60% of patients were receiving angiotensin-converting enzyme inhibitors (ACEI)/angiotensin receptor blocker (ARB), followed by diuretics (40.8%), calcium channel blockers (25.1%) and (β-blockers (12.5%). The majority of patients (> 55%) were either on mono or no drug therapy. Patients on monotherapy were mostly receiving ACEI/ARB (60%). In patients with reduced renal function, use of diuretics, but not ACEI/ARB or CCB, was higher and 41.8% of the patients were on monotherapy compared to 46.6% in patients with normal renal function. The proportion of patients achieving good BP control was 20% with mono­therapy and 28% with combination therapy. Our study suggests that the pattern of anti-hypertensive therapy was generally consistent with inter-national guidelines. Areas of improvement include in­creasing use of ACEI/ARB and diuretics, decreasing the number of untreated patients, and increasing the proportion of patients with well controlled BP in this population.

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