Antihypertensive Drug Prescribing in a Tertiary Hospital in Eastern Nigeria

Purpose: To determine the pattern of antihypertensive medication prescription in a referral hospital in Nigeria and its use by patients.
Methods: By method of convenience sampling, 4954 prescriptions were collected from 376 files of hypertensive patients (>18 years) visiting a referral hospital in Enugu, southeastern Nigeria between June and July 2009, were retrospectively surveyed. Data on visits, antihypertensive medication, nonantihypertensive medication and drug adverse effects were extracted, coded and analyzed.
Results: The mean age of hypertensive patients was 61 years, and an almost equal number of females (49 %) and males (51 %) visited the hospital. The average number of antihypertensive drug per patient was 2.63 ± 0.92 and 90 % of the patients were prescribed more than one drug in their last visit. For individual antihypertensive drugs, hydrochlorothiazide (29.7 %) and lisinopril (20.3 %) were the most prescribed with low-dose aspirin (39.7 %) and non-steroidal anti-inflammatory agents (16.7 %) occurring as most co-prescribed medication. Adverse effects were reported by 11 % of the patients while 18 % of the patients were non-adherent.
Conclusion: The study showed a high use of more than one drug as supported by applicable guidelines hypertension, with diuretics and angiotensin converting enzyme inhibitors ACEIs the being most prescribed probably due to their low-cost and observed efficacy in this setting.