Skip to main content
SpringerLink
Log in

Prescribing pattern of antihypertensive drugs in primary care units in Turkey: results from the TURKSAHA study

  • Pharmacoepidemiology and Prescription
  • Published:
European Journal of Clinical Pharmacology Aims and scope Submit manuscript

Abstract

Objectives

The prescribing pattern of drugs used for treating hypertension changes over time in response to changes in recommended guidelines and innovations in drug formulations, among others. In addition, the classes of antihypertensive drugs used vary among the countries. The aim of this study was to investigate the practice of antihypertensive medications in primary care units in Turkey.

Method

TURKSAHA is a cross-sectional screening study conducted in 1000 primary care units considered to be representative of primary care in Turkey, with the purpose of defining the demographic characteristics, clinical features, rate of blood pressure control achieved and the antihypertensive drugs prescribed for the hypertensive patients treated in these centers. In this analysis, we investigated the agents used in the treatment regimen.

Results

Of the 16,270 patients considered to be eligible for inclusion in the study, 15,187 (93.3%) were on an antihypertensive treatment, and 1083 (6.7%) were receiving no treatment. Patients who received treatment but whose antihypertensive medication was not specified (2290 patients) were subsequently excluded, and the trial was carried out with the remaining 12,897 patients. The mean age of the patients was 60 ± 11 years (60.2% female). Of the 12,897 patients, 75.7% were receiving monotherapy, 19.7% two drugs, 4.1% three drugs and 0.5% four or more drugs. The rate of successful blood pressure control (<140/90 mmHg; for diabetics <130/80 mm Hg) in relation to the number of drugs received was 26.3, 25.9, 24.5 and 26.2%, respectively. Among the patients receiving monotherapy, the most frequently used antihypertensive drug class was angiotensin-converting enzyme inhibitors (30.1%), followed by β-blockers (20.6%), calcium-channel blockers (17.9%), diuretics (15.4%) and angiotensin-receptor blockers (14%).

Conclusion

As in other European countries, the rate of successful blood pressure control was low among hypertensive patients receiving treatment, and despite the inadequacy of monotherapy to control blood pressure, many of the patients continued this treatment regimen. Consistent with the global trend, the most frequently prescribed anti-hypertensives were angiotensin blockers.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Onat A, Doğan Y, Uyarel H et al (2002) Blood pressure levels in Turkish adults: initial trend to improved blood pressure control. Arch Turk Soc Cardiol 30:749–757

    Google Scholar 

  2. Chamontin B, Poggi L, Lang T et al (1998) Prevalence, treatment, and control of hypertension in the French population data from a survey on high blood pressure in general practice, 1994. Am J Hypertens 11:759–762

    Article  PubMed  CAS  Google Scholar 

  3. Joffres MR, Hamet P, MacLean DR, L’italien GJ, Fodor G (2001) Distribution of blood pressure and hypertension in Canada and the United States. Am J Hypertens 14:1099–1105

    Article  PubMed  CAS  Google Scholar 

  4. Sharma AM, Wittchen HU, Kirch W et al (2004) High prevalence and poor control of hypertension in primary care: cross-sectional study. J Hypertens 22:479–486

    Article  PubMed  CAS  Google Scholar 

  5. Wolf-Maier K, Cooper RS, Kramer H et al (2004) Hypertension treatment and control in five European countries, Canada, and the United States. Hypertension 43:10–17

    Article  PubMed  CAS  Google Scholar 

  6. Pittrow D, Kirch W, Bramlage P et al (2004) Patterns of antihypertensive drug utilization in primary care. Eur J Clin Pharmacol 60:135–142

    Article  PubMed  CAS  Google Scholar 

  7. Chobanian AV, Bakris GL, Black HR et al (2003) The seventh report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. The JNC 7 report. JAMA 289:2560–2572

    Article  PubMed  CAS  Google Scholar 

  8. Guidelines Committee (2003) European society of Hypertension-European Society of Cardiology guidelines for the management of arterial hypertension. J Hypertens 21:1011–1053

    Article  Google Scholar 

  9. Siegel D, Lopez J, Meier J, Cunningham F (2001) Changes in the pharmacologic treatment of hypertension in the Department of Veterans Affairs 1997–1999: decreased use of calcium antagonists and increased use of -blockers and thiazide diüretics. Am J Hypertension 14:957–962

    Article  CAS  Google Scholar 

  10. Sturani A, Esposti ED, Serra M et al (2002) Assessment of antihypertensive drug use in primary care in Ravenna, Italy, based on data collected in the PANDORA project. Clin Ther 24:249–259

    Article  PubMed  CAS  Google Scholar 

  11. Esposti LD, Esposti ED, Valpiani G et al (2002) A retrospective, population-based analysis of persistence with antihypertensive drug therapy in primary care practice in Italy. Clin Ther 24:1347–1357

    Article  PubMed  Google Scholar 

  12. Rotmensch HH, Mendelevitch L, Silverberg DS, Liron M (1996) Prescribing pattern of antihypertensive drugs in the community. J Hum Hypertens 10[Suppl 3]:S169–S172

    PubMed  Google Scholar 

  13. Siddiqui S, Ogbeide DO, Karim A, Al-Khalifa I (2001) Hypertension control in a community health centre at Riyadh, Saudi Arabia. Saudi Med J 22:49–52

    PubMed  CAS  Google Scholar 

  14. Crucitti A, Cecchi E, Gensini GF et al (2000) Use of antihypertensive drugs in the Italian hospitals. Pharmacol Res 41:249–253

    Article  PubMed  CAS  Google Scholar 

  15. Wallenius S, Kumpusalo E, Parnanen H, Takala J (1998) Drug treatment for hypertenion in Finnish primary care unit. Eur J Clin Pharmacol 54:793–799

    Article  PubMed  CAS  Google Scholar 

  16. Walley T, Duggan AK, Haycox AR, Niziol CJ (2003) Treatment for newly diagnosed hypertension: patterns of prescribing and antihypertensive effectiveness in the UK. J R Soc Med 96:525–531

    Article  PubMed  Google Scholar 

  17. Gasse C, Stieber J, Döring A, Keil U, Hense HW (1999) Population trends in antihypertensive drug use: results from the MONICA Augsburg project 1984 to 1995. J Clin Epidemiol 52:695–703

    Article  PubMed  CAS  Google Scholar 

  18. Hansson L, Zanchetti A, Carruthers Sg et al, for the HOT Study Group (1998) Effects of intensive blood-pressure lowering and low-dose aspirin in patients with hypertension: Principal results of the Hypertension optimal Treatment (HOT) randomized trial. Lancet 351:1755–1762

    Article  PubMed  CAS  Google Scholar 

  19. Cushman WC, Ford CE, Cutler JA et al, ALLHAT Collaborative Research Group (2002) Success and predictors of blood pressure control in diverse North American settings: the Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT) J Clin Hypertens 4:393–405

    Google Scholar 

  20. Wilkes MS, Doblin BH, Shapiro MF (1992) Pharmaceutical advertisements in leading medical journals: Experts’ assessments. Ann Intern Med 116:912–919

    PubMed  CAS  Google Scholar 

  21. Wang TJ, Ausiello JC, Stafford RS (1999) Trends in antihypertensive drug advertising, 1985–1996. Circulation 99:2055–2057

    PubMed  CAS  Google Scholar 

  22. Manolio TA, Cutler JA, Furberg JD, Psaty BM, Whelton PK, Applegate WB (1995) Trends in pharmacologic management of hypertension in the United States. Arch Intern Med 155:829–837

    Article  PubMed  CAS  Google Scholar 

  23. Psaty BM, Koepsell TD, Yanez ND et al (1995) Temporal patterns of antihypertensive medication use among older adults, 1989 through 1992. An effect of the major clinical trials on clinical practice? J Am Med Assoc 273:1436–1438

    Article  CAS  Google Scholar 

  24. Mehta SS, Wilcox CS, Schulman KA (1999) Treatment of hypertension in patients with comorbidities. Results from the Study of Hypertensive Prescribing Practices (ShyPP). Am J Hypertens 12:333–340

    PubMed  CAS  Google Scholar 

  25. Pears E, Hannaford PC, Taylor MW (2003) Gender, age and deprivation differences in the primary care management of hypertension in Scotland: a cross-sectional database study. Fam Pract 20:22–31

    Article  PubMed  CAS  Google Scholar 

Download references

Acknowledgements

This study was funded by İbrahim Ethem-Menarini, Turkey. We are indebted to all physicians who participated in the data collection, without whom the present study would not have been possible.

Author information

Authors and Affiliations

  1. School of Medicine, Department of Cardiology, Gazi University, Ankara, Turkey

    Adnan Abaci

  2. School of Medicine, Department of Cardiology, Dokuz Eylül University, İzmir, Turkey

    Omer Kozan

  3. SSK Göztepe Hospital, Istanbul, Turkey

    Aytekin Oguz

  4. School of Medicine, Department of Cardiology, Ondokuz Mayıs University, Samsun, Turkey

    Mahmut Sahin

  5. School of Medicine, Department of Cardiology, Akdeniz University, Antalya, Turkey

    Necmi Deger

  6. School of Medicine, Department of Cardiology, Atatürk University, Erzurum, Turkey

    Huseyin Senocak

  7. School of Medicine, Department of Cardiology, Dicle University, Diyarbakır, Turkey

    Nizamettin Toprak

  8. Department of Biostatistics, School of Medicine, Marmara University, İstanbul, Turkey

    Haydar Sur

  9. School of Medicine, Department of Cardiology, Ankara University, Ankara, Turkey

    Cetin Erol

Authors
  1. Adnan Abaci
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Omer Kozan
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Aytekin Oguz
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Mahmut Sahin
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Necmi Deger
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Huseyin Senocak
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Nizamettin Toprak
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Haydar Sur
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Cetin Erol
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Adnan Abaci.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Abaci, A., Kozan, O., Oguz, A. et al. Prescribing pattern of antihypertensive drugs in primary care units in Turkey: results from the TURKSAHA study. Eur J Clin Pharmacol 63, 397–402 (2007). https://doi.org/10.1007/s00228-007-0266-8

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00228-007-0266-8

Keywords

Search

Navigation