(31) Antihypertensive Prescription and Blood Pressure Patterns in Patients with Chronic Kidney Disease at a Nephrology Outpatient Clinic in Lagos University Teaching Hospital, Idi-Araba

Publication Number: 1076

Background: Hypertension and chronic kidney disease (CKD) frequently coexist, requiring multiple antihypertensive agents to achieve blood pressure control.

Objectives: To determine the antihypertensive prescription pattern and its effect on blood pressure control in patients with CKD attending the nephrology outpatient clinic of a tertiary healthcare facility in Lagos, Nigeria.

Methods: A cross-sectional study with retrospective follow-up of 154 participants with CKD who were 18 years of age or older, had at least two clinic visits and consented to participate in the study. A structured, interviewer-administered questionnaire was used to retrieve socio-demographic and clinical data from participants. The etiology of CKD, co-morbid conditions, prescribed antihypertensive medications, clinic blood pressure records, and results of laboratory investigations were retrieved from the participant’s hospital records.

Results: Participants were divided into sextiles based on their baseline systolic and diastolic blood pressure values and the mean of absolute blood pressure reduction was determined for each quartile. One-way ANOVA was used to compare the means of absolute blood pressure reduction across the sextiles. The level of statistical significance was set at P-value less than 0.05. Forty-eight percent of participants were males while the mean age of the study population was 59.5 + 12.1 years. Overall, hypertension was present in 92.9% of participants. The mean number of antihypertensive medications prescribed was 2.8 + 1.1. The most commonly prescribed class was calcium channel blockers (70.8%). A mean reduction of 23.2 + 35.1mmHg and 8.8 + 21.4mmHg respectively was achieved in systolic (SBP) and diastolic (DBP) blood pressures. Mean absolute reduction in both SBP and DBP was largest among individuals with baseline blood pressures in the highest sextiles and decreased progressively. Also, mean absolute reduction in SBP was significantly higher among those prescribed a higher number of antihypertensive medications.

Conclusions: Majority of participants were prescribed antihypertensive medications from at least three classes. Blood pressure reduction was largest among participants with the highest baseline blood pressure. Significantly larger blood pressure reduction was achieved in those prescribed with a higher number of antihypertensive prescriptions.