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Antihypertensive pharmacotherapy in a developing economy: pattern, acquisition costs and conformity to international guidelines in a tertiary-care setting

Journal of Human Hypertension volume 20, pages 894–897 (2006)Cite this article

Acquisition cost of antihypertensive drugs may hamper blood pressure (BP) control. We evaluated prescribing pattern, acquisition cost and cost-effectiveness relationship in 225 black hypertensives attending a tertiary clinic in a developing economy. BP control was achieved in 89 (39.6%), calcium channel blockers were used most frequently (28.4%), but the most cost-effective therapy was the diuretic co-amiloride.

The primary goal of hypertension (HBP) treatment is to reduce the total risk of cardiovascular morbidity and mortality.1, 2 Targets for BP control reflect the ‘safest’ levels of BP in general, and also reflect the ‘safest’ levels in specific clinical settings such as those with comorbid diseases.1, 2 The choice of antihypertensive therapy should, ideally, be evidence-based and comply with internationally acceptable guidelines. Nevertheless, an important consideration in the selection of drug therapy is the acquisition cost. This factor is even weightier in developing economies where the dual dilemmas of low per capita income and lack of medical insurance dampen the ideals of pharmacologic control of BP.

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References

  1. Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. The Sixth Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. Arch Intern Med 1997; 157: 2413–2446.

  2. Guidelines Subcommittee. 1999 World Health Organization – International Society of Hypertension. Guidelines for the Management of Hypertension. J Hypertens 1999; 17: 151–183.

  3. Dias da Costa JS, Fuchs SC, Olinto MT, Gigante DP, Menezes AM, Macedo S et al. Cost effectiveness of hypertension treatment: a population based study. Sao Paulo Med J 2002; 120: 100–104.

    Article  Google Scholar 

  4. Akinboboye O, Idris O, Akinboboye O, Akinkugbe O . Trends in coronary artery disease and associated risk factors in sub-Saharan Africans. J Hum Hypertens 2003; 17: 381–387.

    Article  CAS  Google Scholar 

  5. Adigun AQ, Ishola DA, Akintomide AO, Ajayi AAL . Shifting trends in the pharmacologic treatment of hypertension in a Nigerian tertiary hospital: a real-world evaluation of the efficacy, rationality and pharmaco-economics of old and newer antihypertensive drugs. J Hum Hypertens 2003; 17: 277–285.

    Article  CAS  Google Scholar 

  6. McClellan W, Tuttle E, Issa A . Racial differences in the incidence of hypertensive end-stage renal disease (ESRD) are not entirely explained by differences in the prevalence of hypertension. Am J Kidney Dis 1988; 12: 285–290.

    Article  CAS  Google Scholar 

  7. Chobanian AV, Bakris GL, Black HR, Cushman WC, Green LA, Izzo JL et al. The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. The JNC 7 report. JAMA 2003; 289: 2560–2572.

    Article  CAS  Google Scholar 

  8. Lemogoum D, Seedat YK, Mabadeje AFB, Mendis S, Bovet P, Onwubere B et al. Recommendations for prevention, diagnosis and management of hypertension and cardiovascular risk factors in sub-Saharan Africa. J Hypertens 2003; 21: 1993–2000.

    Article  CAS  Google Scholar 

  9. Appel LJ . The verdict from ALLHAT – thiazide diuretics are the preferred initial therapy for hypertension. JAMA 2002; 288: 3039–3042.

    Article  Google Scholar 

  10. Edwards PR, Steyn K, Walters L, Smart A, Gammon S, Lombard CJ . Hypertension management of medical aids patients attending private practices. South Afr Med J 1999; 89: 160–164.

    CAS  Google Scholar 

  11. Oyewo EA, Ajayi AA, Ladipo GOA . A therapeutic audit in the management of hypertension in Nigerians. East Afr Med J 1989; 66: 458–467.

    CAS  PubMed  Google Scholar 

  12. National Expert Committee on Non-Communicable Diseases in Nigeria. Non-communicable diseases in Nigeria. Final report of a national survey. Federal Ministry of Health and Social Services, Lagos 1997.

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  1. Department of Medicine, College of Medicine, University of Lagos, Lagos, Nigeria

    C O Amira & N U Okubadejo

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  1. C O Amira
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  2. N U Okubadejo
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Correspondence to N U Okubadejo.

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Amira, C., Okubadejo, N. Antihypertensive pharmacotherapy in a developing economy: pattern, acquisition costs and conformity to international guidelines in a tertiary-care setting. J Hum Hypertens 20, 894–897 (2006). https://doi.org/10.1038/sj.jhh.1002080

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