A Study of the Prescription Patterns of Antihypertensive Drugs in Patients Attending the Outpatient Department of Medicine at a Tertiary Care Hospital

Background Hypertension is a major global public health concern and a leading risk factor for cardiovascular, cerebrovascular, and renal diseases. Despite the availability of evidence-based guidelines for hypertension management, discrepancies often exist between recommended practices and real-world prescribing patterns. This study aimed to evaluate the prescription pattern of antihypertensive drugs in patients attending the outpatient department (OPD) of medicine at a tertiary care hospital and to assess the adherence of prescribed therapies to the Eighth Joint National Committee (JNC 8) guidelines. Methods This was a cross-sectional, single-center, observational study conducted over two years, with data collection spanning six months (April to September 2023) in the OPD of medicine of a tertiary care hospital. A total of 334 patients diagnosed with primary hypertension, meeting the inclusion criteria, were enrolled after obtaining informed consent. Data were collected from printed hospital management information system (HMIS)-generated prescriptions, which included diagnosis, past history, and antihypertensive treatment, along with patient interviews. Data regarding demographics, comorbidities, and antihypertensive prescriptions were collected and analyzed. Prescriptions were also evaluated for adherence to JNC 8 guidelines. Results Among 334 patients, 182 (54.49%) were male and 152 (45.51%) were female, with a mean age of 57.2 ± 11.39 years. The majority (57.49%) belonged to the 40-60 years age group. A total of 536 antihypertensive drugs were prescribed, with an average of 1.60 ± 0.65 drugs per prescription. Among the 334 prescriptions analyzed, calcium channel blockers (CCBs) were the most commonly prescribed class (76.95%), followed by angiotensin receptor blockers (ARBs) (60.18%), diuretics (27.25%), beta-blockers (BBs) (18.26%), angiotensin-converting enzyme inhibitors (ACEIs) (5.99%), and alpha-blockers (0.6%). Monotherapy was prescribed in 36.23% of cases, while 63.77% received combination therapy, with two-drug combinations being most common (41.62%). Among monotherapy prescriptions, CCBs were preferred (71.9%), followed by ARBs (20.66%). The most frequent two-drug combination was CCB + ARB (61.87%), while the three-drug combination of CCB + ARB + diuretic was most common (60.66%). In four-drug combinations, CCB + ARB + BB + diuretic was most frequently used (76.93%). Comorbidities were present in 52.69% of patients, with diabetes mellitus (68.18%) being the most prevalent. In diabetic hypertensive patients, CCBs (80.83%) were most commonly prescribed; 82.63% of prescriptions adhered to JNC 8 guidelines. Conclusion The study revealed a high prevalence of CCB and ARB use, both as monotherapy and combination therapy, in accordance with national and international guidelines. However, prescribing trends were influenced by factors such as physician preference, comorbidities, and individual clinical judgment. Regular prescription audits and awareness programs focusing on evidence-based guidelines are essential to ensure rational antihypertensive drug use and optimal patient outcomes.