title: Prescription patterns of antihypertensives in a community health centre in Mexico City: a drug utilization study.
abstract: Hypertension is highly prevalent; in Mexico, the 2012 National Health and Nutrition Survey reported a prevalence of hypertension of 31.5% in the adult population. Pharmacological treatment is the commonest intervention and has been shown to reduce cardiovascular mortality and morbidity, and total mortality. Accordingly, the type and number of antihypertensives used and the outcome - in terms of blood pressure (BP) control - are important. Therefore, our purpose is to learn the pattern of antihypertensive drug prescription and explore the determinants of BP control in an urban population in Mexico. A retrospective cross-sectional drug utilization study was conducted. Medical records from a community health centre were searched to identify those corresponding to patients diagnosed with hypertension; information upon antihypertensives used and control of the disease was carefully retrieved. A logistic regression model was built to know the main determinants of BP control. A sample of 345 clinical records of interest was identified. Most patients received antihypertensives (86.4%); the leading medications used were angiotensin-converting enzyme inhibitors, 63.8%; beta-blockers (26.5%), diuretics (19.8%), angiotensin-receptor blockers (15.8%) and calcium-channel blockers (6.4%). Only the age (≥55 years) and BMI (>30) of the patients, and the age of the doctors (≥55 years), had an important influence on BP control. Obesity is a particular and important determinant of uncontrolled hypertension; it is worth to act on body weight, on an individual basis. As lack of control has been also tied to elderly doctors, an education programme could be envisaged.
authors.affiliation: Nursing Obstetric National School and Department of Public Health, Autonomous National University of Mexico UNAM, Mexico, Mexico.
authors.forename: Adela
authors.initials: A
authors.lastname: Alba-Leonel
authors.affiliation: Centro de Estudios sobre la Seguridad de los Medicamentos (CESME), Universidad de Valladolid, Valladolid, Spain.
authors.forename: Alfonso
authors.initials: A
authors.lastname: Carvajal
authors.affiliation: Centro de Estudios sobre la Seguridad de los Medicamentos (CESME), Universidad de Valladolid, Valladolid, Spain.
authors.forename: Immaculada
authors.identifier: http://orcid.org/0000-0003-4423-4493
authors.initials: I
authors.lastname: Fierro
authors.affiliation: Sanitary District Benito Juarez, Public Health Services of the Federal District, Mexico, Mexico.
authors.forename: Fernando
authors.initials: F
authors.lastname: Castillo-Nájera
authors.affiliation: Sanitary District Benito Juarez, Public Health Services of the Federal District, Mexico, Mexico.
authors.forename: Oscar
authors.initials: O
authors.lastname: Campos-Ramos
authors.affiliation: Department of Public Health, Faculty of Medicine, Autonomous National University of Mexico (UNAM), Mexico, Mexico.
authors.forename: Antonio
authors.initials: A
authors.lastname: Villa-Romero
authors.affiliation: Department of Pharmacology, Faculty of Medicine, Autonomous National University of Mexico (UNAM), Mexico, Mexico.
authors.forename: Juan
authors.initials: J
authors.lastname: Molina-Guarneros
mesh_terms: D000368:Aged; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D003151:Community Health Centers / Q000639:trends*; D003430:Cross-Sectional Studies; D011307:Drug Prescriptions; D004363:Drug Utilization / Q000639:trends*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology*; D008297:Male; D008800:Mexico / Q000453:epidemiology; D008875:Middle Aged; D009749:Nutrition Surveys / Q000379:methods / Q000639:trends; D012189:Retrospective Studies
chemical_list: D000959:Antihypertensive Agents
keywords: antihypertensives; blood pressure control; utilization study