Trends of antihypertensive agents in patients with hypertension and coronary artery disease in a tertiary hospital of China.

Background Except for hypertension control, antihypertensive agents play an essential role in the secondary prevention of coronary artery disease. Objective This study aimed to describe the use of antihypertensive agents in patients with hypertension and coronary artery disease by assessing the compliance to the updated European and Chinese hypertension guidelines through analyzing the frequencies, monthly trends and the influencing factors of antihypertensive agents. Setting Beijing Friendship Hospital, Capital Medical University, a 2000-bed tertiary Chinese university teaching hospital. Method Prescriptions of patients diagnosed with hypertension and coronary artery disease were extracted from medical records of this tertiary hospital from 2013 to 2016. Frequencies, trends, co-existing prescription patterns of five classes of antihypertensive agents were analyzed. Influencing factors of prescription patterns were evaluated by logistic regression. Main outcome measure The frequencies and monthly trends of different antihypertensive agents within four years. Result In total, 286,155 prescriptions met the inclusion criteria. β-blockers (64,0%) were the most widely used antihypertensive agents, followed by calcium channel blockers (53.57%), angiotensin receptor blockers (42.6%), angiotensin-converting-enzyme inhibitors (23.7%) and diuretics (16.4%). During the 4 years, frequencies of β-blockers, angiotensin receptor blockers, calcium channel blockers and diuretics increased over time, while that of angiotensin-converting-enzyme inhibitors declined. Multivariate logistic regression indicated that gender, age and comorbidities including stroke, diabetes, heart failure and arrhythmia could affect antihypertensive selections to varying degrees. Conclusion The compliance to guidelines is overall well for patients with hypertension and coronary artery disease, but improvements is needed for patients with type 2 diabetes. Multi-center studies with large-scale data are required to further assess the usage of antihypertensive agents in patients.