Use of Antihypertensive Medications in Patients with type -2 Diabetes in Ajman, UAE

Optimal reduction in blood pressure with antihypertensive agents helps to prevent microvascular and macrovascular complications of diabetes. The objective of the study was to evaluate the current utilization pattern of antihypertensive medications among patients with diabetes and coexistent hypertension as per the JNC seventh report guidelines. A Cross-sectional survey was conducted among patients with diabetes attending outpatient department of Internal Medicine at a hospital at Ajman. Medical records of patients were used to obtain diagnostic, demographic and drug use information. Univariate analysis was performed using Chi-square and t- test followed by logistic regression to compute independent predictors. Of 132 patients with diabetes, uncomplicated hypertension (HTN) was coexistent in 81% (107/132) of patients. Males constituted 49.5% (53/107) of the total. Mean (SD) age of patients with HTN was 55.1(10.1) years higher than those without HTN 49.6 (9.9) years (P<0.01). Higher number of patients with HTN had duration of diabetes < 5years than those >5 years (P=0.04). While adjusting the significant factors, only duration of diabetes was statistically significant (adjusted OR=1.06; CI 95% (1.003-1.116) P= 0.03 among patients with HTN. 63.6% (68/107) prescriptions contained one drug antihypertensive drug, 27.1 % (29/107) two drugs and 7.4% (8/107) no anti-hypertensive drug were prescribed. Angiotensin converting enzyme inhibitors/ Angiotensin receptor blockers (ACEI/ARBs) followed by diuretics were commonly prescribed drugs. ARBs with diuretics were the most frequent two drug combinations. The antihypertensive utilization pattern was similar in both gender and age groups. Results represent the current prescribing trend for anti-hypertensive agents among patients with diabetes that is in accordance with JNC-7 recommendations.