Assessment Of Adverse Drug Reactions Among Hypertensive Patients Receiving Treatment in Tertiary Care in Rajasthan

Abstract

Adverse drug reactions (ADRs) pose significant challenges to the healthcare system and the quality of life of hypertensive patients. This prospective observational cohort study aims to evaluate the incidence, severity, and types of ADRs among hypertensive patients receiving anti-hypertensive therapy in a tertiary care hospital in Rajasthan. We recruited 222 hypertensive patients and monitored them at baseline, 24 hours, 7 days, and 30 days. The study found that 44% of participants experienced ADRs, with 7?ing severe, 25% moderate, and 68% mild. The most common ADRs were associated with ARBs (45%), followed by diuretics (25%) and CCBs (21%), with hyperkalemia and angioedema being the most frequently reported ADRs. These findings underscore the need for meticulous monitoring and patient education to mitigate ADRs in hypertensive patients.

Keywords

Introduction

Table 1: Socio-demographic characteristics of the study participants

A total of 222 patients participated in the study, with a mean age of 59.5 ± 11.85 years. The majority were over 60 years old (51.4%) and married (77.9%). Most participants were retired or housewives (66.2%), and 68.9% had a normal BMI. Newly diagnosed patients and those with less than one year of treatment comprised 69.8% of the cohort.

Table 2:  WHO causality assessment of ADRs (WHO, 2020).

Among the 222 participants, 98 patients (44%) reported experiencing ADRs. The WHO-UMC causality assessment categorized these reactions as certain (24.5%), probable/likely (35.7%), possible (18.4%), and unlikely (21.4%).

Table 3: Severity of reported ADRs by modified Hartwig and Siegel scale (Hartwig and Siegel, 1992).

Among the 98 patients with ADRs, 7.1% had severe reactions, 24.5% had moderate reactions, and 68.4% had mild reactions.

Table 4: Adverse Drug Reaction Reported

Hyperkalemia and angioedema were the most frequent ADRs, each affecting 18.4% of patients on ARBs. Reported from the data collected from patients' files.

Table 5: Cumulative of ADR reported.

ADRs were most common among patients on ARBs (44.9%), followed by diuretics (24.5%) and CCBs (21.4%).

Table 6: Co-morbidities among hypertensive patients

Diabetes mellitus was the most prevalent comorbidity (28.4%) among the 102 patients with comorbidities.

DISCUSSION

This study highlights the significant incidence of ADRs among hypertensive patients receiving treatment, with 44% experiencing ADRs. The majority of these were mild, but a notable proportion were moderate or severe, underscoring the need for careful monitoring and management. ARBs were the most common drug class associated with ADRs, particularly hyperkalemia and angioedema.

The findings emphasize the importance of regular monitoring, patient education, and effective communication between healthcare providers and patients. By proactively managing ADRs, healthcare professionals can improve patient adherence to antihypertensive therapy and overall treatment outcomes.

CONCLUSION:

Assessing ADRs in hypertensive patients is crucial for optimizing treatment and ensuring patient safety. A comprehensive approach involving patient history reviews, monitoring, education, and documentation can significantly reduce the risks associated with ADRs. Collaboration among healthcare providers is essential to tailor treatment plans and improve patient outcomes. Ongoing follow-up and participation in adverse event reporting systems are vital to maintaining high standards of care in hypertensive management.

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