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USE OF ANTI-HYPERTENSIVE DRUGS OVER A TEN YEAR PERIOD IN HYPERTENSIVE PATIENTS FROM A PRIMARY CARE POPULATION IN MALAYSIA: PP.19.226

Objective: Hypertension is a common problem in outpatient practice. Usage of anti-hypertensive medication is influenced by availability and clinical guidelines. This study examines the use of anti-hypertensive drugs over a 10 year period, in patients attending an outpatient primary care clinic. Design and Methods: This is part of a retrospective cohort study of patients registered at the Department of Primary Care Medicine Clinic, University Hospital, Malaysia. Patients aged 30 years and over without known heart, stroke or peripheral vascular disease in 1998, were randomly selected. Demographic data and anti-hypertensive drug usage in 1998, 2002 and 2007 (± 6months) were captured. All statistical analyses were done using SPSS version 13.0 Results: 1136 patients were entered into the study (mean age 56.2 years (SD ± 10.2); 34.7% male). In 1998, 2002 and 2007, 654 (57.6%), 827 (73.1%) and 893 (86.0%) patients respectively were on pharmacological treatment for hypertension. Mean systolic blood pressure (BP) of patients treated for hypertension was significantly reduced from 146.0/ 87.8 mmHg (SD ± 18.6/ 10.0) in 1998 to 136.0/ 79.5 mmHg (SD ± 16.4/ 8.3) in 2007. The percentage of hypertensive patients achieving BP control (BP <140/90 mmHg) improved significantly from 21.3% in 1998 to 52.9% in 2007. The number and types of anti-hypertensives used over the ten years are shown in Table 1. ACE-inhibitors/ AII Receptor blockers saw the biggest rise in usage from 8.7% (1998) to 51.2% (2007). A rise was also seen with calcium channel blockers and diuretics. In contrast there was a decrease in β-blocker use. By 2007, 60.6% of patients were on two or more drugs in combination compared to 23.2% in 1998. Figure 1. No caption available. Conclusion: Treatment of hypertension over a 10 year period showed significant improvement. This could be explained by the greater number of anti-hypertensive drugs used in combination and the change in prescribing pattern. This change follows local guidelines on treatment of hypertension. However, more effort is needed to get all patients treated to target.