EVALUATION OF PRESCRIBING PATTERNS AND GUIDELINE ADHERENCE OF ANTIHYPERTENSIVE THERAPY IN A TERTIARY-CARE TEACHING HOSPITAL IN INDIA

Background: Hypertension is one of the most prevalent chronic diseases globally and a major modifiable risk factor for cardiovascular morbidity and mortality. Rational prescribing and adherence to evidence-based treatment guidelines are crucial to ensure optimal control and cost-effective therapy. Objective: To assess the prescribing pattern of antihypertensive drugs and evaluate adherence to guideline-directed therapy in patients with essential hypertension attending a tertiary-care teaching hospital. Methods: A prospective, observational, cross-sectional study was conducted over six months. Data regarding demographics, comorbidities, prescribed drugs, dosage, and combination therapy collected, analysed descriptively. Prescriptions were assessed for adherence to the Indian Guidelines on Hypertension (IGH-IV, 2019) and ISH 2020 recommendations. Results: The 200 patients (mean age 55.7 ± 11.2 years; 56% males), 68% were known hypertensives, and 32% were newly diagnosed. A total of 387 antihypertensive agents were prescribed, averaging 1.93 ± 0.6 drugs per prescription. Combination therapy predominated (54%), most commonly ARB + CCB (42.6%), followed by ARB + diuretic (25.9%). CCBs (28.7%) and ARBs (26.6%) were the most frequently used classes. Guideline adherence was noted in 71% of prescriptions. Generic prescribing was observed in 62% of drugs, and 78% of agents were from the WHO Essential Medicines List. Mild adverse effects occurred in 7% of patients. Conclusion: Prescribing patterns at the tertiary-care centre were largely consistent with current hypertension management guidelines, with a clear preference for ARB + CCB combinations. Regular audits and educational initiatives can reinforce evidence-based hypertension management in resource-limited healthcare settings.