Abstract

PRESCRIPTION OF ANTIHYPERTENSIVE DRUGS IN MOROCCO IN AMBULATORY CARE: A MULTICENTER STUDY

Ghizlane BERRADA EL AZIZI¹*, Samir AHID¹, Saadia ABIR-KHALIL², Fedoua ELLOUALI³, Mohammed CHERTI³, Abdelali BOUKILI⁴, Mohammed HASSAR¹, Yahia CHERRAH¹

¹Research Team of Pharmacoepidemiology & Pharmacoeconomics. Laboratory of Pharmacology & Toxicology, Faculty of Medicine & Pharmacy, University Mohammed V- Souissi, Rabat, Morocco.
²Department of Cardiology. Clinic Agdal. Rabat, Morocco.
³Department of Cardiology B. University Hospital Ibn Sina. Rabat, Morocco.
⁴Department of Cardiology, military hospital of armed Mohammed V, 11000 Rabat, Morocco.

Abstract

Purpose: High blood pressure (HBP) is a major public health problem in Morocco. The purpose of this study is to evaluate prescribing in actual practice among cardiologists, following therapeutic recommendations and to analyze the role of different therapeutic classes. Methods: This is an observational study conducted between November 2010 and May 2012, including 1223 outpatients with essential HBP followed at cardiology centers. We have retained the European Society of Hypertension (ESH) and the European Society of Cardiology (ESC) definition and classification of hypertension. Results: We recruited 1223 hypertensive patients of which 71% (n=868) had complicated hypertension. Monotherapy was prescribed for 25% of the hypertensive patients. The most prescribed therapeutic classes in monotherapy were angiotensin II receptor blockers (ARBs, 41.5%), angiotensin converting enzyme inhibitors (ACEI, 24.8%), calcium channel blockers (CCBs, 22.5%), diuretics (5.9%) and beta-blockers (β-blockers, 5.2%). More than 51% of patients received a dual therapy with 59.24% receiving a fixed combination of antihypertensive agents. The prescription of a triple therapy concerned 18.1%, while only 5.2% received quadruple therapy. The prescription of the β-blockers was more frequent in hypertensive patients with coronary artery disease, heart failure and heart rhythm disorders. The ACEI were prescribed more frequently in hypertensive patient with diabetes, with coronary artery diseases, heart failure, a stroke, or renal impairment. Conclusion: Therapeutic classes used in the treatment of hypertension are varied. The diuretics, CCBs and ARBs are the most prescribed and β-blockers the least prescribed. Complicated HBP leads to preferential prescription of diuretics, ARBs and CCBs.

Keywords: Hypertension, Antihypertensive, Ambulatory consultation