Antihypertensive medication among young hypertension inpatients in Shenyang city

  Objective  To examine antihypertensive medication among young hypertension inpatients in Shenyang city and to provide evidences for rational drug use in young hypertensive patients.

  Methods  Using convenient sampling, we extracted clinical records of 3 000 hypertension patients aged 18 – 45 years and hospitalized in cardiovascular departments of 3 grade A tertiary hospitals in Shenyang city between January 2013 to January 2017. The data on antihypertensive medication of the inpatients were analyzed retrospectively.

  Results  Of the inpatients, 18.03% (541), 36.80% (1 104), and 45.17% (1 355) were diagnosed as grade I, II, and III hypertension; 25.80% (774) were complicated with left ventricular hypertrophy, 8.40% (252) with carotid atherosclerosis, 15.07% (452) with coronary heart disease, 6.1% (184) with heart failure, 13.60% (408) with ischemic stroke, 6.80% (204) with hemorrhagic stroke, and 5.33% (160) with chronic kidney disease, respectively. During the hospitalization, 29.60% (888) and 70.40% (2 112) received monotherapy and combined antihypertensive medication. For the inpatients with monotherapy, 20.72% (184) were treated with angiotensin-converting enzyme inhibitor (ACEI), 17.12% (152) with angiotensin receptor blocker (ARB), 19.82% (176) with β-blocker, 33.78% (300) with calcium channel blocker (CCB), and 8.56% (76) with diuretic; the drug use for antihypertension differed significantly by the grade of hypertension among the inpatients (χ² = 44.87, P < 0.001). Among the inpatients with combined therapy, the proportions of medication regimen were 16.29% (344) for ACEI/ARB + CCB, 9.28% (196) for ACEI/ARB + diuretics, 16.67% (352) for CCB + β-blocker, 19.70% (416) for ACEI/ARB + β-blocker + CCB, 26.33% (556) for ACEI/ARB + CCB + diuretic, and 11.74% (248) for ACEI/ARB + β-blocker + diuretic; there was a significant difference in medication regimen between the inpatients with grade II and grade III hypertension (χ² = 138.45, P < 0.001).

  Conclusion  Antihypertensive medication regimen differs by the grade of the disease among young hypertension inpatients and the course of the disease needs to be concerned in rational drug use in the young hypertension patients.