Antihypertensive regimen among primary hypertension inpatients, 2015 – 2018: an analysis on medical records of three tertiary hospitals in Anshan city

  Objective   To examine antihypertensive regimens among primary hypertension inpatients during 2015 – 2018 in Anshan city of Liaoning province for evaluating rational medication of hypertensive patients.

  Methods   Using stratified random sampling through hospital information systems, we extracted medical records of 3 600 primary hypertension patients hospitalized at three tertiary first-class hospitals during 2015 – 2018 (300 records/per year/per hospital) in Anshan city. The clinical characteristics and antihypertensive regimens of the inpatients were statistically analyzed.

  Results  Of all the inpatients, 525 (14.58%),1032 (28.67%), and 2043 (56.75%) were diagnosed with hypertension of stage I, II, and III, respectively. The proportions of the inpatients having concomitant diseases were 21.17% for left ventricular hypertrophy, 8.36% for carotid atherosclerosis, 14.28% for coronary heart disease, 9.00% for heart failure, 12.42% for ischemic stroke, 7.47% for hemorrhagic stroke, and 6.31% for chronic kidney disease. Among all the inpatients during the hospitalizations, 1 004 (27.89%) had single antihypertensive medication and 2 596 (72.11%) had combined antihypertensive medication. Among the monotherapy regimens, calciumion antagonists (CCB) was the most frequently used drug in 325 (32.37%)of the inpatients, followed by angiotensin converting enzyme inhibitors (ACEI) in 210 (20.92%) of the inpatients. Of the inpatients with the combined regimens, 588 (22.65%) had the medication of ACEI/angiotensin receptor blocker (ARB) plus CCB plus diuretic and 587 (22.61%) had the medication of ）ACEI/ARB plus β-receptor blocker plus CCB. The antihypertensive regimens differed significantly by hypertension stage among the inpatients (χ² = 1 922.86, P < 0.001).

  Conclusion  For the primary hypertensive patients hospitalized during 2015 – 2018 in Anshan city, more than a half had stage III hypertension and left ventricular hypertrophy, coronary artery disease, and ischemic stroke were major concomitant diseases; CCB was a main monotherapy and ACEI/ARB plus CCB plus diuretic was a main combined antihypertensive regimen in the treatment of the inpatients during hospitalization.