Clinical pharmaceutical analysis the treatment of hypertension in patients with diabetes mellitus in the hospital Mnazi Mnoja (Zanzibar)

Abstract

Treatment of arterial hypertension (AH) in patients with type II diabetes mellitus (DM) is a significant problem of practical medicine in many aspects.

In order to study the pertinence of the schemes in practice of the treatment of AH in diabetic patients with current guidelines we analyzed medical records of 348 patients aged 38 to 70 years (mean age, 49 ± 0,43 years), corresponding to the criteria in the hospital named after V.I. Lenin (Mnazi Mmoja) Zanzibar (Tanzania). The investigated were divided into two groups matched for age and sex composition of the groups. The first group consisted of 301 patients with a combination of AH and DM (study group), and the second one (control) consisted of 47 hypertensive patients without DM.

It has been found the preference to use of converting enzyme (ACE) inhibitors, respectively 83.1% and 91.5% according to the groups. In the group of the study was much larger variation of combinations of drugs, which is comparable with the existing guidelines of prescribing medicines according to the state of the target organs. The prevailing use of a combination of an ACE inhibitor, calcium channel blocker and diuretic (69.4%). There was irrational look because of absence in the arsenal of drugs non- dihydropyridine calcium channel blockers, modern beta-blockers (bisoprolol, carvedilol) and the widespread use of thiazide diuretics as monotherapy use against DM.

Based on the completed research the practical recommendations involved phasing of antihypertensive drugs prescription (angiotensin-converting enzyme inhibitor or a non- dihydropyridine calcium channel blocker, and then adding of the other preparations due to the therapeutic effect).

Key words: arterial hypertension, diabetes mellitus, medication, rational treatment.