Prescription of pharmacotherapy and blood pressure control among hypertensive outpatients in two semi-urban hospitals in Cameroon: a cross-sectional study

Pan Afr Med J. 2020 Oct 5:37:122. doi: 10.11604/pamj.2020.37.122.21156. eCollection 2020.

Abstract

Introduction: several international guidelines are available on drug treatment for hypertension, but the control of hypertension remains very poor in sub-Saharan Africa (SSA). We investigated the commonly prescribed antihypertensive drugs and their association with blood pressure (BP) control in adult Cameroonians.

Methods: we consecutively recruited hypertensive outpatients attending the Buea and Limbe Regional Hospitals (southwest region of Cameroon). Controlled BP was defined as BP < 140/90mmHg in hypertensive patients aged 60 years or younger, diabetics or patients with chronic kidney disease or a BP < 150/90mmHg in non-diabetic hypertensive patients older than 60 years of age (JNC8).

Results: of the 408 participants included (mean age 61.1 years), 67% were female. The median duration of hypertension was 6 years and the median duration of the current treatment was 22 weeks. Commonly prescribed antihypertensives were calcium channel blockers (CCB, 35.1%), thiazide/thiazide-like diuretics (TD/TLD, 26.1%) and angiotensin-converting enzyme inhibitors (ACEI, 19.5%). The median monthly cost of antihypertensive was 10279.6 CFA (approximately equal to US$ 172). Seventy percent (70%) of participants were receiving at least 2 drugs, with ACEI+TD/TLD, CCB+TD/TLD, and ACEI+CCB+TD/TLD being the most frequent combination. The rate of BP control was 52% overall, and 60% in participants on monotherapy.

Conclusion: CCBs were the most prescribed single antihypertensive drugs in this setting while ACEI+TD/TLD was the most common combination. About half of patients were at target BP control levels Improving availability and affordability of these medications may improve hypertension management and control.

Keywords: Cameroon; Hypertension; antihypertensive drugs; blood pressure.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Antihypertensive Agents / administration & dosage*
  • Antihypertensive Agents / economics
  • Antihypertensive Agents / pharmacology
  • Blood Pressure / drug effects*
  • Cameroon
  • Cross-Sectional Studies
  • Drug Costs
  • Drug Therapy, Combination
  • Female
  • Hospitals, Urban
  • Humans
  • Hypertension / drug therapy*
  • Male
  • Middle Aged
  • Outpatients
  • Practice Patterns, Physicians' / statistics & numerical data*
  • Young Adult

Substances

  • Antihypertensive Agents