Prescribing Trends of Antihypertensive Medications: An Observational Study in a Tertiary Care Hospital in India

TL;DR

This study examines how antihypertensive medications are prescribed to newly diagnosed patients in an Indian hospital, finding a preference for ARBs and rational drug use.

Contribution

The study provides current insights into antihypertensive prescribing trends in India, aligned with updated ACC/AHA and WHO guidelines.

Findings

ARBs were the most commonly prescribed antihypertensive drugs.

Combination therapy was more frequent than monotherapy, with an average of 1.56 drugs per patient.

Prescribing practices aligned with WHO indicators for rational drug use.

Abstract

Background and objectives: Hypertension is a major contributor to cardiovascular morbidity and mortality and represents a significant public health burden in India and blood pressure control rates remain low, contributing substantially to cardiovascular disease (CVD) risk. Appropriate pharmacological management at the time of diagnosis is essential for effective blood pressure control and prevention of complications. This study aimed to assess the demographic profile, comorbidities, and antihypertensive prescribing patterns among newly diagnosed hypertensive patients in a tertiary care hospital. The distribution of patients was classified according to the American College of Cardiology/American Heart Association (ACC/AHA) hypertension guidelines (2017), with consideration of subsequent updates, including the most recent 2025 recommendations, and prescribing trends based on World Health Organization (WHO) prescribing indicators were also analyzed.

Methods: This cross-sectional observational study included 250 adult patients newly diagnosed with hypertension. Data regarding demographic characteristics, lifestyle factors, body mass index (BMI), associated comorbidities, and prescribed antihypertensive medications were collected. Patients were categorized by age, BMI, and hypertension staging as per the latest ACC/AHA guidelines. Drug utilization patterns were evaluated using WHO prescribing indicators.

Results: The mean age of participants was 54.9 ± 13.0 years, and the mean BMI was 27.8 ± 5.9 kg/m². Individuals aged over 50 years constituted 60% of the study population, and approximately 70% were overweight or obese. Most patients were married, literate, and belonged to socio-economic class III, representing individuals with moderate educational attainment, semi-skilled or clerical occupations, and a middle-range household income relative to the urban population. Diabetes mellitus was the most common comorbidity (47.6%), followed by CVD (22.8%). Combination therapy was prescribed more frequently than monotherapy, with an average of 1.56 antihypertensive drugs per patient. Angiotensin receptor blockers (ARBs) were the most commonly prescribed agents. WHO indicators demonstrated rational prescribing, with high use of generic medicines and essential drugs.

Conclusion: The study highlights a high burden of hypertension among older, overweight, and diabetic individuals. Prescribing practices predominantly favored ARBs and reflected rational, guideline-consistent management of hypertension in a tertiary care setting.