What is the clinical evidence from this study?

Study design: Cross-Sectional. Population: Hypertension (n=99). Intervention: Antihypertensive agents. Primary outcome: Drug utilization pattern of antihypertensive medications.

June 8, 2026Open Access

Drug Utilization Pattern of Antihypertensive Agents in a Tertiary Care Hospital

Q: What does this research mean for the field?

In a tertiary care setting, antihypertensive prescribing patterns largely align with guideline-preferred first-line therapies, predominantly utilizing calcium channel blockers and angiotensin receptor blockers, with moderate adherence to the National List of Essential Medicines. Novelty: ClaimNovelty.CONFIRMATORY. Consensus alignment: ConsensusAlignment.SUPPORTS_CONSENSUS.

Key Result

Calcium channel blockers were the most frequently prescribed antihypertensive drug class (65.6%), with 58.9% of all prescribed medications drawn from the National List of Essential Medicines.

Key Points

To evaluate the drug utilization pattern of antihypertensive medications among hypertensive patients in a tertiary care hospital.
Conducted a cross-sectional observational study among 99 hypertensive patients.
Documented patient sociodemographic characteristics, medication types, and prescribed doses.
Assessed medication use against WHO core prescribing indicators and India's NLEM 2022.
58.6% of patients were aged 60 or above, with 52.5% being males.
Calcium channel blockers were used in 65.6% of patients, with monotherapy accounting for 39.4%.
58.9% of prescribed medications were from the NLEM.

Study Design

Type

Cross-Sectional (n=99)

Multicenter

Structured PICO

Population

99 adult patients with hypertension receiving antihypertensive treatment for over one month at a tertiary care hospital in India.

Exposure

Antihypertensive medications (prescribing patterns)

Outcome

Drug utilization pattern of antihypertensive medications

Antihypertensive prescribing patterns in this tertiary care hospital align with guideline-preferred first-line agents, predominantly utilizing calcium channel blockers and angiotensin receptor blockers.

Limitations

Conducted at a single tertiary institution, limiting applicability to the wider population
Formal recruitment data including refusal rates were not systematically recorded
Sample size may not provide sufficient statistical power for inferential comparisons
Confidence intervals were not reported for key proportions
Cross-sectional design limits the ability to establish temporal relationships or causality
Clinical outcomes such as blood pressure control and medication adherence were not directly measured
Percentage of antihypertensive medications prescribed by generic name was not assessed
Prescriber-level factors and hospital formulary constraints were not assessed
Timing of initial hypertension diagnosis was not assessed

Abstract

Introduction Hypertension constitutes a significant global health challenge and is a major contributor to cardiovascular morbidity and death, particularly in economically developing nations. Although effective antihypertensive medications are widely accessible, satisfactory blood pressure regulation is often not achieved due to suboptimal prescribing practices. Periodic evaluation of how medications are prescribed and consumed in clinical practice is therefore necessary to bridge existing gaps and guide improvements in patient care. The primary objective of this study was to evaluate the drug utilization pattern of antihypertensive medications among hypertensive patients attending the outpatient department of a tertiary care hospital. The first secondary objective was to assess antihypertensive prescribing patterns in relation to World Health Organization (WHO) core prescribing indicators. The secondary objective was to examine adherence to the National List of Essential Medicines (NLEM) 2022 of India. Methods A cross-sectional observational study was conducted among 99 patients diagnosed with hypertension visiting the outpatient clinic of a tertiary care hospital over a period of 18 months, from March 2024 to August 2025. Patient information including sociodemographic characteristics, total number of medications prescribed, therapeutic drug categories and individual agents, dosing parameters, duration of antihypertensive treatment, and utilization of fixed-dose combinations (FDCs) were systematically documented. Medication use was assessed utilizing the standard WHO core prescribing indicators, and evaluation of medications sourced from the essential drug list was done using the NLEM 2022 of India. Results A total of 58 (58.6%) patients belonged to the ≥60-year age group, and 52 (52.5%) were males. Monotherapy was the most commonly prescribed treatment, accounting for 39 (39.4%) patients, followed by FDCs in 38 (38.4%) patients. Calcium channel blockers (CCBs) emerged as the most widely utilized drug class, prescribed in 65 (65.6%) patients. Among monotherapy recipients, CCBs and angiotensin receptor blockers (ARBs) were the predominantly used agents, accounting for 22 (22.2%) and 14 (14.1%) patients, respectively. Among free drug combinations, CCBs with ARBs were the most common, prescribed in 10 (10.1%) patients. Among FDCs, CCBs with ARBs were the most commonly prescribed in 11 (11.1%) patients, followed by CCBs with beta-blockers in seven (7%) and ARBs with diuretics in six (6.1%) patients. The mean number of drugs per prescription was 1.4±0.6, and 79 (58.9%) medications were drawn from the NLEM. Conclusion Antihypertensive prescribing patterns were broadly consistent with guideline-preferred first-line drug classes, with CCBs and ARBs as the prominent agents. A substantial proportion of medications were drawn from the NLEM, though the proportion prescribed outside the NLEM highlights the need for ongoing prescription monitoring. Periodic evaluation of antihypertensive prescribing trends in tertiary care hospital settings is recommended to inform quality improvement initiatives in hypertension management.

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