Multi-Centered Prospective Observational Study on Prescribing Pattern of Anti-Hypertensives in Diabetes Mellitus Type 2 and Chronic Kidney Disease Patients in Eastern Districts of Telangana

Background

The most prevalent lifestyle diseases are Diabetes Mellitus type 2 (DM2) and Hypertension (HTN), especially in older age groups, which leads to Chronic Kidney Disease (CKD) as the most possible comorbidity. Management of HTN involves various drugs with fixed doses and combinations, while specialized regimens are implemented for patients with other comorbidities like DM2 and CKD. Treatment of blood pressure in diabetics is complicated and requires combinational therapy with regular monitoring of both blood pressure and blood glucose to prevent diabetic nephropathy. Chronic Kidney Disease (CKD) describes the gradual loss of kidney function, and it is the major complication of DM and HTN. Management of CKD involves determining the cause of disease and eliminating or controlling it, with most CKD cases intensified by HTN, DM, infections, hypovolemic conditions, and salt intake. Despite the fact that lifestyle modifications and pharmacological interventions are frequently necessary to achieve the best blood pressure goals in patients with diabetes and CKD.

Materials and Methods

This cross-sectional study collected data on 300 patients, of whom 200 had type 2 diabetes and 100 had CKD as concomitant diseases and were regularly using anti-hypertensives.

Results

The results of our study are astonishing because minimizing or avoiding risk factors like alcohol and smoking have improved the patient condition significantly in both DM2 and CKD, along with HTN. Starting with ACEi and ARBs initially had a great impact on achieving the blood pressure goal in DM2. Specific beta blockers are recommended in patients with CVD risk. Salt restriction, using antihypertensives like ARBs, and CCBs are used predominantly to treat blood pressure and proteinuria in CKD patients. Diuretics are implemented to treat symptoms like edema and low urine output, to reduce fluid overload on the heart, and to prevent heart failure.

Conclusion

The clinical pharmacist plays an important role in designing the therapeutic regimen and lifestyle changes for the best patient outcome.