Healthy Skepticism Library item: 11856
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Publication type: Journal Article
Okechukwu I, Mahmud A, Bennett K, Feely J.
Choice of first antihypertensive - are existing guidelines ignored?
Br J Clin Pharmacol 2007 Oct 22;
http://www.blackwell-synergy.com/doi/abs/10.1111/j.1365-2125.2007.03005.x
Abstract:
What is already known about this subject
- Recommended treatment guidelines for hypertension have been developed to assist GPs’ decisions about appropriate therapies.
- The British Hypertension Society’s (BHS) 2004 guidelines recommend initial drug choice based on age, and avoidance of beta-adrenoceptor blockers in diabetes.
What this study adds
- Prescribing of first-line antihypertensives in Ireland appears guided by age, but mainly for those under 55 years.
- Adherence to the guidelines was in part related to patient gender.
- Presence of concomitant diabetes had a greater influence on the choice of therapy than age of patient.
Aims To determine adherence to hypertension guidelines in relation to age and diabetes.
Methods The Irish HSE-PCRS prescribing database identified patients initiating antihypertensive monotherapy in 2005. Logistic regression predicted the likelihood of therapy according to guidelines.
Results The odds ratio (OR) of receiving therapies according to the guideline recommendations in those <55 years vs. >/=55 years was 1.31 (95% CI 1.26, 1.37). Diabetics were more likely than nondiabetics to receive antihypertensives other than beta-adrenoceptor blockers (OR 2.97, 95% CI 2.74, 3.21).
Conclusions Our findings show some adherence to the guidelines in relation to age but selective prescribing of antihypertensives for diabetics.
E-mail: okechuki@tcd.i.e
