Introduction

This study aimed to examine the medication prescriptions for hypertension in a class 1 and grade A hospital in Shanxi province to provide references for clinical rational drug use.

Methods

An inpatient medical record inquiry system was used to evaluate the use of antihypertensives in a hypertensive population (age ≥ 18 years old) who received a prescription for one or more antihypertensives between January 2017 and December 2019. The hypertensive population was categorized into grades (1, 2, and 3), age groups, and different comorbidities to analyze the medication prescriptions. Drug analysis included angiotensin-converting enzyme inhibitor (ACEI), angiotensin receptor antagonist (ARB), calcium channel blocker (CCB), diuretics, and beta-receptor blockers (B-RB). SPSS16.0 was used for statistical analysis, including one-way analysis of variance (ANOVA,) chi-squared test, and multifactor logistic regression analysis.

Results

The overall control rate of blood pressure was 60.79%. The control rates of single, double, triple, and quadruple antihypertensives were 70.08%, 59.97%, 56.27%, and 45.23%, respectively. There were more cases of grade 3 than grades 1 and 2. The 18–65 years group was larger than the 66–79 years and ≥ 80 years groups. With the increase in grade, the prescription rate of the single drug decreased and the prescription rate of the combination drug increased, but this phenomenon was not obvious in different age groups. The most common drug prescribed for monotherapy was CCB; CCB combined with B-RB had the highest drug use in the double group by age or grade. Statistically significant differences were detected in the type of comorbidities between different age groups (P < 0.001), while only some differences were observed between different grades. Also, statistically significant differences were observed in the drugs prescribed for patients with hypertension with different comorbidities (P < 0.001). Factors influencing the efficiency of antihypertensives included sex, age, diabetes, heart failure, and usage of CCB and B-RB. The prescription rate of ARB combined with B-RB was relatively higher in grade 2 cases. B-RB was the primary drug for patients with diabetes, significantly increasing the blood glucose level.

Conclusions

The medication prescription of this hospital was in line with the requirements of China’s hypertension prevention and treatment guidelines. The pathophysiology of patients with hypertension in different age groups, increased use of combination drugs, and rational drug requirement should be considered when prescribing drugs.

中文翻译：

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山西省一级甲等医院高血压用药处方分析

介绍

本研究旨在了解山西省某一级甲等医院高血压用药处方情况，为临床合理用药提供参考。

方法

使用住院病历查询系统评估2017年1月至2019年12月期间接受一种或多种降压药处方的高血压人群（年龄≥18岁）中降压药的使用情况。将高血压人群分为等级（1 、2 和 3)、年龄组和不同的合并症来分析药物处方。药物分析包括血管紧张素转换酶抑制剂 (ACEI)、血管紧张素受体拮抗剂 (ARB)、钙通道阻滞剂 (CCB)、利尿剂和 β 受体阻滞剂 (B-RB)。采用SPSS16.0进行统计分析，包括单因素方差分析（ANOVA）卡方检验和多因素logistic回归分析。

结果

血压总体控制率为60.79%。单、双、三、四联降压药的控制率分别为70.08%、59.97%、56.27%和45.23%。3级病例多于1级和2级。18-65岁组大于66-79岁和≥80岁组。随着年级的增加，单药处方率下降，联合用药处方率上升，但这种现象在不同年龄段不明显。单药治疗最常用的药物是 CCB；CCB联合B-RB在双组中按年龄或级别的药物使用率最高。不同年龄组合并症类型差异有统计学意义（P < 0.001)，而不同等级之间仅观察到一些差异。此外，在为具有不同合并症的高血压患者开具的药物中观察到统计学上的显着差异（P  < 0.001）。影响抗高血压药疗效的因素包括性别、年龄、糖尿病、心力衰竭以及 CCB 和 B-RB 的使用。ARB联合B-RB的处方率在2级病例中相对较高。B-RB 是糖尿病患者的主要药物，显着增加血糖水平。

结论

该医院的用药处方符合我国高血压防治指南的要求。处方药物时应考虑不同年龄组高血压患者的病理生理、联合用药的增加以及合理的用药需求。