An-Najah Staff

Background and objective  Anti-hypertensive medications are recommended for prevention of recurrent ischemic stroke in hypertensive and normotensive patients. The objective of this study was to analyze the use of anti-hypertensive therapy in acute ischemic stroke survivors.
Methods  All ischemic stroke survivors discharged from Al-watani governmental hospital in Palestine from August 2006 until September 2007 were investigated. Demographic data, clinical characteristics, and different classes of anti-hypertensive medications prescribed to stroke survivors were analyzed using SPSS 15. Results  One hundred and twenty four ischemic stroke survivors were identified, of which 80 (64.5%) had a documented history of hypertension (HTN). Two thirds of the survivors (n = 82; 66.1%) were prescribed anti-hypertensive medications, mostly as mono-therapy, at discharge. Angiotensin-converting enzyme inhibitors (ACEI) 65 (45.6%), followed by diuretics 41 (34.5%) were the most common drug classes prescribed. ACEI were used in combination with diuretics in 29 (23.4%) survivors. Among survivors with a documented history of HTN, 70 (85.5%) were prescribed anti-hypertensive medications at discharge while 12 (8.5%) of survivors with no history of HTN were prescribed anti-hypertensive medications at discharge.
Conclusion  In this study, the use of anti-hypertensive medications as a mono-therapy was common among those with a history of hypertension but not among those without a history of hypertension.

Background and objective

Anti-hypertensive medications are recommended for prevention of recurrent ischemic stroke in hypertensive and normotensive patients. The objective of this study was to analyze the use of anti-hypertensive therapy in acute ischemic stroke survivors.

Methods

All ischemic stroke survivors discharged from Al-watani governmental hospital in Palestine from August 2006 until September 2007 were investigated. Demographic data, clinical characteristics, and different classes of anti-hypertensive medications prescribed to stroke survivors were analyzed using SPSS 15.

Results

One hundred and twenty four ischemic stroke survivors were identified, of which 80 (64.5%) had a documented history of hypertension (HTN). Two thirds of the survivors (n = 82; 66.1%) were prescribed anti-hypertensive medications, mostly as mono-therapy, at discharge. Angiotensin-converting enzyme inhibitors (ACEI) 65 (45.6%), followed by diuretics 41 (34.5%) were the most common drug classes prescribed. ACEI were used in combination with diuretics in 29 (23.4%) survivors. Among survivors with a documented history of HTN, 70 (85.5%) were prescribed anti-hypertensive medications at discharge while 12 (8.5%) of survivors with no history of HTN were prescribed anti-hypertensive medications at discharge.

Conclusion

In this study, the use of anti-hypertensive medications as a mono-therapy was common among those with a history of hypertension but not among those without a history of hypertension.

Background and objective: Anti-hypertensive medications are recommended for prevention of recurrent ischemic stroke in hypertensive and normotensive patients. The objective of this study was to analyze the use of anti-hypertensive therapy in acute ischemic stroke survivors.
Methods: All ischemic stroke survivors discharged from Al-watani governmental hospital in Palestine from August 2006 until September 2007 were investigated. Demographic data, clinical characteristics, and different classes of anti-hypertensive medications prescribed to stroke survivors were analyzed using SPSS 15.
Results: One hundred and twenty four ischemic stroke survivors were identified, of which 80 (64.5%) had a documented history of hypertension (HTN). Two thirds of the survivors (n=82; 66.1%) were prescribed anti-hypertensive medications, mostly as mono-therapy, at discharge. Angiotensin-converting enzyme inhibitors (ACEI) 65 (45.6%), followed by diuretics 41 (34.5%) were the most common drug classes prescribed. ACEI were used in combination with diuretics in 29 (23.4%) survivors. Among survivors with a documented history of HTN, 70 (85.5%) were prescribed anti-hypertensive medications at discharge while 12 (8.5%) of survivors with no history of HTN were prescribed anti-hypertensive medications at discharge.
Conclusion: In this study, the use of anti-hypertensive medications as a mono-therapy was common among those with a history of hypertension but not among those without a history of hypertension. 

Macrovascular complications are common in diabetic hypertensive patients. Appropriate antihypertensive therapy and tight blood pressure control are believed to prevent or delay such complication. Objective: To evaluate utilization patterns of antihypertensive agents and blood pressure (BP) control among diabetic hypertensive patients with and without ischemic heart disease (IHD). Methods: Retrospective cohort study of all diabetic hypertensive patients attending Al-watani medical center from August 2006 until August 2007. Proportions of use of different antihypertensive drug classes were compared for all patients receiving 1, 2, 3, or 4 or more drugs, and separately among patients with and without IHD. Blood pressure control (equal or lower 130/80 mmHg) was compared for patients receiving no therapy, monotherapy, or combination therapy and separately among patients with and without IHD. Results: 255 patients were included in the study; their mean age was 64.4 (SD=11.4) years. Sixty one (23.9%) of the included patients was on target BP. Over 60% of the total patients were receiving angiotensin-converting enzyme inhibitors (ACEI)/ angiotensin receptor blocker (ARB), followed by diuretics (40.8%), calcium channel blockers (25.1%) and beta-blockers (12.5%). The majority (> 55%) of patients were either on mono or no drug therapy. More than 55% of patients with controlled BP were using ACE-I. More than half (50.8%) of the patients with controlled BP were on combination therapy while 42.3% of patients with uncontrolled BP were on combination therapy (p=0.24). More patient in the IHD achieved target BP than those in non-IHD group (p=0.019). Comparison between IHD and non-IHD groups indicated no significant difference in the utilization of any drug class with ACE-I being the most commonly utilized in both groups. Conclusions: Patterns of antihypertensive therapy were generally but not adequately consistent with international guidelines. Areas of improvement include increasing ACE-I drug combinations, decreasing the number of untreated patients, and increasing the proportion of patients with controlled BP in this population.

BACKGROUND: Hypertension and ischemic heart disease (IHD) are among the most prevalent modifiable risk factors for stroke. Clinical trial evidence suggests that antihypertensive medications are recommended for prevention of recurrent ischemic stroke in hypertensive and normotensive patients.
OBJECTIVES: The objectives of this study were to analyze and evaluate the utilization of antihypertensive medication for acute ischemic stroke (AIS) or transient ischemic attack (TIA) survivors in relation to recent recommendations and guidelines and to compare their use among patients with or without IHD.
METHODS: This was a retrospective cohort study of all patients with AIS/TIA attending the hospital from July 1, 2008 to December 31, 2008. Demographic data, clinical characteristics, different classes of antihypertensive medications, and different antihypertensive combinations prescribed to AIS/TIA survivors were analyzed among patients with and without IHD. Statistical Package for Social Sciences (SPSS) program version 15 was used for data analysis.RESULTS: In all, 383 AIS/TIA survivors were studied, of which 66 (19.5%) had a documented history of IHD. Three quarters
(n = 260; 76.9%) of AIS or TIA survivors received antihypertensive medication, mostly as monotherapy, at discharge. The majority of patients (n = 201, 59.5%) were prescribed angiotensin-converting enzyme inhibitors (ACEIs). Patients with IHD were significantly prescribed more β-blockers than patients without IHD (P = .003). A history of hypertension, a history of diabetes mellitus, and age were significantly associated with prescription of antihypertensive medications at discharge (P < .001, P < .001, and P < .001, respectively
CONCLUSION: Patterns of antihypertensive therapy were commonly but not adequately consistent with international guidelines. Screening stroke survivors for blood pressure control, initiating appropriate antihypertensive medications, and decreasing the number of untreated patients might help reduce the risk of recurrent strokes and increase survival.

Macrovascular complications are common in diabetic hypertensive patients. Appropriate antihypertensive therapy and tight blood pressure control are believed to prevent or delay such complication.
Objective: To evaluate utilization patterns of antihypertensive agents and blood pressure (BP) control among diabetic hypertensive patients with and without ischemic heart disease (IHD).
Methods: Retrospective cohort study of all diabetic hypertensive patients attending Al-watani medical center from August 2006 until August 2007. Proportions of use of different antihypertensive drug classes were compared for all patients receiving 1, 2, 3, or 4 or more drugs, and separately among patients with and without IHD. Blood pressure control (equal or lower 130/80 mmHg) was compared for patients receiving no therapy, monotherapy, or combination therapy and separately among patients with and without IHD.
Results: 255 patients were included in the study; their mean age was 64.4 (SD=11.4) years. Sixty one (23.9%) of the included patients was on target BP. Over 60% of the total patients were receiving angiotensin-converting enzyme inhibitors (ACEI)/ angiotensin receptor blocker (ARB), followed by diuretics (40.8%), calcium channel blockers (25.1%) and beta-blockers (12.5%). The majority (> 55%) of patients were either on mono or no drug therapy. More than 55% of patients with controlled BP were using ACE-I. More than half (50.8%) of the patients with controlled BP were on combination therapy while 42.3% of patients with uncontrolled BP were on combination therapy (p=0.24). More patient in the IHD achieved target BP than those in non-IHD group (p=0.019). Comparison between IHD and non-IHD groups indicated no significant difference in the utilization of any drug class with ACE-I being the most commonly utilized in both groups.
Conclusions: Patterns of antihypertensive therapy were generally but not adequately consistent with international guidelines. Areas of improvement include increasing ACE-I drug combinations, decreasing the number of untreated patients, and increasing the proportion of patients with controlled BP in this population.

To investigate the frequency of potential antihypertensive drug interactions among patients with cardiovascular diseases receiving antihypertensive medications.
Methods: The study took place in Nablus, Palestine starting April through October 2003. Patients with cardiovascular diseases (n=876) or who were receiving one or more antihypertensive medications were evaluated. All drugs prescribed for the patients were obtained from their medical files. A drug interaction database was developed based on updated Drug Interaction Facts to examine potential and level of drug interactions in each patient's regimen. Data were entered and analyzed using SPSS software.
Results: The number of "unique" pairs of potential drug interactions among the antihypertensive agents present in the data was 433. These included 16 cases (3.7%) level one; 34 cases (7.8%) level 2; 116 cases (26.8%) level 3; 136 cases (31.4%) level 4, and 131 (30.3%) level 5 interactions. Both increasing age and number of drugs were significantly associated with the potential for significant interactions at all levels with a p value less than 0.025.
Conclusions: This study found a high frequency of potential drug interactions with agents typically used for hypertension. Similar investigations need to be carried out among patients with other types of chronic diseases. Drug interaction software might be necessary in governmental pharmacy departments.