Objective: To describe the use of drugs to combat hypertension and to assess prescription in function of their counterindications to diuretics and beta blockers.
Design: A descriptive cross-sectional study by means of an outside audit of clinical records.
Setting: 11 urban Health Districts opened before 1991.
Participants: 326 histories of adult hyperintense patients under pharmacological treatment were chosen at random (June-December, 1994).
Measurements and main results: Data were gathered on age, sex, present and former medication, reason for change, and counter-indications to diuretic or beta blocker treatments. Average age was 64.7 (SD 11.6); 66% were women. 437 active principles (AP) were used, of which Enalapril (68 patients) and Captopril (67) were the most common. 203 patients (62.3%; Cl 95%, 57.0-67.5) took one AP; 90 (27.6%; Cl 95%, 22.8-32.5) took two APs; 30 (9.2%), three APs; and 3 (0.9%), four APs. 47.8% of monotherapy was performed with ACE inhibitors; 27.6% with calcium antagonists; 15.3% with diuretics; 7.9% with beta blockers and 1.5% with alpha inhibitors. Diuretics were the drugs most commonly used in association.
Conclusions: There is little use of diuretics and beta blockers, but two-thirds of the prescription of other treatments are justified by a counter-indication to first-choice drugs.