ANTIHYPERTENSIVE COMBINATIONS FOR ACHIEVING GOAL BLOOD PRESSURE USING THE JOINT NATIONAL COMMITTEE (JNC) 7 GUIDELINE IN A NIGERIA TEACHING HOSPITAL
NKEIRUKA GRACE OSUAFOR, CHINWE VICTORIA UKWE
Department of Clinical Pharmacy and Pharmacy Management, Faculty of Pharmaceutical Sciences, University of Nigeria Nsukka, PMB 410001, Enugu State, Nigeria.
Afr. J Pharm Res Dev; Volume 12(1): 109-118 ; 2020
The Joint National Committee (JNC7) guideline recommends a combination of antihypertensive medications for achieving target blood pressure. The objective of this study was to evaluate antihypertensive combinations and target blood pressure (BP) goals using JNC7 guidelines in patients with hypertension. A retrospective study was carried out among 679 patients treated for hypertension between 2004 and 2012 in the University of Nigeria Teaching Hospital Ituku-Ozalla Enugu State. Sociodemographic details, medication and clinical data were collected from 201 patients whose medical record met the eligibility criteria. Data were analyzed using both descriptive and inferential statistics. The association between use of antihypertensive combination and achieving BP control was tested with Chi-Square and results presented in frequencies and percentages. Logistic regression was used to predict BP control. P-value < 0.05 was considered significant. The result indicated that most of the patients were women 276 (55.0%) and within the age group of 50-55 years. More than half 294 (58.8%) of the prescriptions were two drug-combinations. A combination of Angiotensin Converting Enzyme Inhibitors (ACEI) and Calcium Channel Blockers (CCB) with thiazide diuretics was mostly prescribed for more than two drug combinations. Forty-three percent cases of stage 1 hypertension were treated with two drug-combinations whereas 111 (22.2%) of stage 2 hypertension cases were managed with more than two drug-combinations. The overall BP goal achieved was 249 (49.8%). Thirty-five percent of the BP goal achieved was attributed to two drug-combinations. In conclusion, more patients received two drug combinations compared to more than two drug combination and two drug combinations were more effective in achieving goal BP.
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KEYWORDS: Hypertension, Antihypertensive combinations, JNC7, BP control.