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Original
Research Article
Adherence to International Guidelines in the Management
of Hypertension in a Tertiary Hospital in Nigeria
VU Odili*1,
EK Oghagbon2, NA Ugwa3, UM
Ochei1, and OE Aghomo1
1Dept.
Of Clinical Pharmacy & Pharmacy Practice, Faculty of
Pharmacy, University of Benin, Benin City, Nigeria,
2Pathology Dept. College of Medicine, Delta State
University, Abraka, Nigeria, 3Pharmacy
Department, University of Benin Teaching Hospital, Benin
City, Nigeria.
Correspondence:
E-mail:
vuodili@yahoo.com
Tel: +2348023432237
Tropical
Journal of Pharmaceutical Research, June
2008; 7(2):
945-952
Abstract
Purpose: The role of physicians in the
overall management of hypertension and their adherence
to the JNC VII, WHO/ISH and ESH guidelines were examined
in this study.
Method: Case notes of hypertensive
patients diagnosed between 1 January 2004 and 30
September 2005, in the Cardiology Clinic of
University of Benin Teaching Hospital were retrieved for
evaluation. They were assessed for adherence to the JNC
VII, WHO/ISH and ESH guidelines, in the management of
hypertension.
Result: Five hundred and one case notes
were used in the study. Prevalence of hypertension was
highest in the Grade 2 category (36%). More women (60%)
than men (40%) were affected, with a diagnostic mean
systolic blood pressure (SBP); male (164.0mmHg ± 21.9),
female (163.7 mmHg ± 18.8) and mean diastolic blood
pressure (DBP); male (100.1 mmHg ± 13.2), female (97.3
mmHg ± 13.1). After commencing treatment, mean SBP and
DBP for male and female were (131.8 mmHg ± 11.6; 84.3
mmHg ± 7.5), and (132.3 mmHg ± 11.5 83.2 mmHg ± 7.6),
respectively. The commonest co-morbidity was diabetes
mellitus (18%). Co-morbidity was commonest in Grade 2
(34%) and Grade 3 hypertension (34%). Almost half of the
subjects (49%) were on a two-drug combination while 14%
were on monotherapy. Calcium channel blockers were the
most commonly prescribed anti-hypertensive drug (31%)
followed by diuretics (30%). In combination drug
regimen, diuretics were the commonest (74%). There was
no evidence of body weight management in hypertension.
Conclusion: Physicians in this hospital
fairly complied with the stated guidelines, but do not
appear to have recommended lifestyle modifications to
their hypertensive patients.
Keywords: Adherence, Guidelines,
Hypertension, Management. |
