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, non-antihypertensive 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.