PHYSICIAN ADHERENCE TO HYPERTENSION GUIDELINES IN ANKARA

Objective: Hypertension is an independent risk factor for cardiovascular disease. Clinical trials have documented that antihypertensive therapy reduces cardiovascular complications in hypertensive individuals. Although the awareness of high blood pressure has improved, the percentage of patients whose blood pressure is controlled has remained unchanged. In this study, we evaluated the adherence of physician to hypertension guidelines. Material and Method: Clinical and demographic characteristics of 711 patients were collected in Ankara, Turkey. A self-reported medical history related to past history of hypertension, diabetes, hyperlipidemia, corona, artery disease, coronary artery by-pass graft operation and cerebrovascular accident was obtained. Medications used regularly for the control of hypertension during two months preceding the interview and classes of prescribed anti hypertensive drugs were recorded. Prescription records for hypertension medications were obtained from Intercontinental Marketing Services (IMS)-Health Turkey between 2000-2005. Results: As a first line antihypertensive therapy, (Angiotensin Receptor Blocker) ARBs are ranked first (33.5%), (Angiotensin Converting Enzyme inhibitor) ACEI ranked second (21.2%), and followed by beta-blockers (14..1%), and calcium canal blockers (CCB) (12.8%). According to the IMS-Health data, ACEI were the most common prescribed, and beta blockers were the second, CCB were the third and ARB were the forth common prescribed anti hypertensive drug in Turkey in 2005. One hundred forty four diabetic patients (55%) were using ACEI or ARB and 29 (14%) were using beta blockers as a first line antihypertensive therapy. 60.9% of the patients were using more than one antihypertensive drug. Conclusion: Our results showed that despite wide declaration, international guidelines have had limited effect on changing physician behavior. We need to be more careful in achieving antihypertensive therapy in accordance with hypertension guideline.