Study of Prescribing Pattern and Adverse Drug Reactions in Hypertensive Patients with Comorbidities as per JNC 8 Hypertension Guidelines in a Tertiary Care Hospital of Punjab

Author(s): Parminder Singh1 , Rahat Kumar Sharma2 , Jaswinder Singh3

BACKGROUND Adverse Drug Reactions (ADRs) to treatment in patients having hypertension with comorbidities is common; however, information about their incidence, severity and is scanty. Such patients are generally prescribed with multiple medications representing different calls of antihypertensive agents to control the blood pressure. Joint National Committee (JNC 8) has published the guidelines on the basis of evidence-based literature for the management of high BP in adults. This study was planned to study the ADRs associated with the drug-treatments prescribed as per JNC-8 guidelines in such patients. METHODS This study was conducted among patients prescribed with antihypertensive agents in medical OPD of SGRDIMS&R, Amritsar which is a tertiary care teaching hospital in Punjab. The study period was February 2019 - January 2020 i.e. for a period of one year. A total of 167 ADRs were detected, documented, assessed, and reported during the study period. Assessment of the ADRs revealed that diabetes mellitus is the most common association comorbidity in patients having hypertension and comorbidity. RESULTS The most common type of ADR was seen in prescribed four drug combination followed by three drugs and one drug prescribed. Two drug combination was the most suitable for such patients and among these, CCB + ACEI and CCB + ARB were the most tolerated in such cases. Causality assessment revealed that 27.5% of ADRs were possibly drug-related and 70.6% were mild in nature. Preventability of ADRs was assessed and it revealed that 74% of ADRs was preventable. CONCLUSIONS Drug combination of two drugs was best tolerated in such patients and such patients should be evaluated for comorbidities before prescribing drug treatment.