Antihypertensive Drugs patterns in Diabetes Mellitus and Their Impact on Glycemic Control

Omran, Amir

	Antihypertensive Drugs patterns in Diabetes Mellitus and Their Impact on Glycemic Control
Kerbala Journal of Medicine
Article 1, Volume 9, Issue 2, 2016, Pages 2534-2542 PDF (0 K)
Author
Amir Omran
Abstract
background: Hypertension management is paramount important in diabetic patients for cardiovascular events reduction. The utilization patterns of antihypertensive agents in diabetic patients must be consistent with recommended guidelines practice to produce a positive metabolic effect on glycemic control with proper control blood pressure and good compliance. Objectives: The study aims to evaluate utilization prescribing pattern of five groups of antihypertensive agents among Type2 diabetic hypertensive patients and to explore the adherence to prescribing existing guidelines and their impacts on glycemic control. Design: retrospective descriptive ,cross sectional study Patients and Methods: A total of 230 Hypertensive Type2 diabetes patients on diet , Metformin and sulphonylureas drugs were enrolled in the study in diabetic clinic at Imam Al-Hussien medical city . The study was done between Jan 2009 And Jan 2014. The attendants' patients used five groups of the Anti-Hypertensive agents in single or in combinations patterns Angiotensin Converting enzymes inhibitor(ACEI), Angiotensin Receptor Blocker(ARB), Calcium Channels Antagonist(CCA), Beta Blocker(BB), Diuretics(Thiazide)). The study followed five groups of antihypertensive drugs for three months to evaluate prescribing patterns accordance to the evidence base guidelines and compare their impact on glycemic control. The study include gender, Age, age distribution, Glycemic control. The study excluded endocrine, liver, and renal diseases, and patients using steroids. Results: The majority of the patients on Antihypertensive drugs 191 patients (83%) were receiving monotherapy including ACEI 77 ( 33.5%) patient, ARB 46( 20%)patient, BB 60(26.1%) patint, CCB 6 patients (2.6%),Thiazide 2 (0.9%) patients, while two or three drugs combined patterns formed 39 ( 16.95%) patient. The proper and adequate glycemic control of both genders are 25.2% . The proper glycemic control of males 40.9% and in females16,7%( P˂0.05) , There were no significant differences of the impact on glycemic control compared between five groups, ACE or ARB compared with single BB (Atenolol, Metaprolol) or CCB, Diuretics, as monotherapy or polytherapy combination patterns. Conclusion; The utilization patterns of Antihypertensive agents (ACEI,ARBS,BBS) were more commonly prescribed followed by CCB, Thiazide Diuretics ,irrespective of mono or polytherapy. The majority of the patients were on monotherapy pattern. There was no significant difference among the five groups of Antihypertensive drugs regarding the impact on glycemic control.
Keywords
Type; Antihypertensive drugs; Glycemic control; Hypertension

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