A STUDY ON UTILIZATION OF ANGIOTENSIN-CONVERTING ENZYME INHIBITORS AND ANGIOTENSIN RECEPTOR BLOCKERS IN PATIENTS WITH CARDIOVASCULAR DISEASES

  • Anuroop Sood Department of Pharmacy Practice, NGSM Institute of Pharmaceutical Sciences, Nitte (Deemed to be University), Mangaluru, Karnataka, India.
  • Jismi Joseph Department of Pharmacy Practice, NGSM Institute of Pharmaceutical Sciences, Nitte (Deemed to be University), Mangaluru, Karnataka, India.
  • Sneha Mathew Department of Pharmacy Practice, NGSM Institute of Pharmaceutical Sciences, Nitte (Deemed to be University), Mangaluru, Karnataka, India.
  • Subramanyam K Department of Cardiology, K. S. Hegde Medical Academy, Nitte (Deemed to be University), Mangaluru, Karnataka, India.
  • Rajesh Ks Department of Pharmacy Practice, NGSM Institute of Pharmaceutical Sciences, Nitte (Deemed to be University), Mangaluru, Karnataka, India.
  • Bharath Raj Kc Department of Pharmacy Practice, NGSM Institute of Pharmaceutical Sciences, Nitte (Deemed to be University), Mangaluru, Karnataka, India.

Abstract

Objectives: The objective of this study was to assess the prescribing pattern, most common indication, and adverse effects associated with angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs) in patients with cardiovascular diseases, and to identify the risk factors associated with cardiovascular diseases in a tertiary care hospital.

Methods: A prospective observational study was carried out for a period of 6 months from October 2016 to March 2017 in both inpatients and outpatients of the cardiology department. Patients received either ACEIs or ARBs were enrolled in the study. The relevant details of the patients were collected from the patient case note and treatment chart and data analyzed.

Results: Of 100 patients, 23.0% were female and 77.0% were male. Among them, majority of patients were in the age group of 41–60 years. Diabetes mellitus (39%), smoking (20%), and alcohol (14%) were the common risk factors. The most common indications of ACEIs were found to be ischemic heart diseases (IHDs) (17%) followed by hypertension (HTN)/IHD (12%), and IHD/heart failure (12%). Main indications of ARBs were found in HTN/ IHD (16%). Utilization of ACEIs (70%) was found to be higher when compared with ARBs (30%). Ramipril (69%) and telmisartan (18%) were the most commonly used ACEIs and ARBs, respectively. While analyzing the adverse effects of ACEIs and ARBs, about 5.71% of patients were identified with ramipril induced dry cough.

Conclusions: The complications of cardiovascular diseases can be reduced by knowing the incidence of risk factors and alternative therapy can be initiated by assessing the incidence of adverse drug reactions related to ACEIs and ARBs

Keywords: Angiotensin-converting enzyme inhibitors, Adverse drug reactions, Angiotensin receptor blockers, Cardiovascular diseases, Drug utilization, Risk factors.

Author Biographies

Anuroop Sood, Department of Pharmacy Practice, NGSM Institute of Pharmaceutical Sciences, Nitte (Deemed to be University), Mangaluru, Karnataka, India.

Department of Pharmacy Practice,

Ngsm Institute of Pharmaceutical Sciences

Nitte (deemed tobe University)

Mangaluru

Jismi Joseph, Department of Pharmacy Practice, NGSM Institute of Pharmaceutical Sciences, Nitte (Deemed to be University), Mangaluru, Karnataka, India.

Department of Pharmacy Practice,

Ngsm Institute of Pharmaceutical Sciences

Nitte (deemed tobe University)

Mangaluru

Sneha Mathew, Department of Pharmacy Practice, NGSM Institute of Pharmaceutical Sciences, Nitte (Deemed to be University), Mangaluru, Karnataka, India.

Department of Pharmacy Practice,

Ngsm Institute of Pharmaceutical Sciences

Nitte (deemed tobe University)

Mangaluru

Subramanyam K, Department of Cardiology, K. S. Hegde Medical Academy, Nitte (Deemed to be University), Mangaluru, Karnataka, India.

Department of Pharmacy Practice,

Ngsm Institute of Pharmaceutical Sciences

Nitte (deemed tobe University)

Mangaluru

Rajesh Ks, Department of Pharmacy Practice, NGSM Institute of Pharmaceutical Sciences, Nitte (Deemed to be University), Mangaluru, Karnataka, India.

prof & head,
Department of Cardiology, K S Hegde Medical Academy, Nitte (Deemed to be University), Derlakatte, Mangaluru

Bharath Raj Kc, Department of Pharmacy Practice, NGSM Institute of Pharmaceutical Sciences, Nitte (Deemed to be University), Mangaluru, Karnataka, India.

Department of Pharmacy Practice,

Ngsm Institute of Pharmaceutical Sciences

Nitte (deemed tobe University)

Mangaluru

References

1. Muhit A, Rahman O, Raihan SZ, Asadurzzman M, Akbar MA, Sharmir N, et al. Cardiovascular disease prevalence and prescription pattern at a tertiary level hospital in Bangladesh. J Appl Pharm Sci 2012;2:80-4.
2. Chauhan S, Aeri BT. Prevalence of cardiovascular diseases in India and its economic impact: A review. Int J Sci Res Publ 2013;3:1-5.
3. WHO. National Cardiovascular Diseases. Available from: http://www.searo.who.int/india/topics/cardiovascular_diseases/en/. [Last accessed on 2017 Mar 26].
4. Kradjan WA. Cardiac and vascular disorders. In: Koda-Kimble MA, Young LY, Alldredge BK, Corelli RL, Gaglielma BJ, Kradjan WA, et al editors. Applied Therapeutics: The Clinical Use of Drugs. 9th ed. New York: Lippincott Williams and Wilkin’s; 2009. p. 18-35.
5. Newby DE, Grubb NR, Bradbury A. Cardiovascular diseases. In: Walker ID, Colledge NR, Ralston SH, Penman ID, editors. Davidson’s Principles and Practice of Medicine. 22nd ed. New York: Churchill Livingstone Elsevier; 2014. p. 528.
6. Matteti UV, Cidda M, Batchu MK, Martha S. Study of prescribing pattern of antihypetensives in South India population. Int J Basic Clin Pharmacol 2014;3:303-7.
7. Deszi CA. Different therapeutic choices with ARBs. Am J Cardiovasc Drug 2016;16:255-66.
8. Rajasekhar DG, Prasanna GU, Chandrakanth P. Prescribing pattern of antihypertensive drugs based on compelling indications with hypertension. Int J Pharm Pharm Sci 2015;8:72-5.
9. WHO. Introduction to Drug Utilization Research. Available from: http://www.apps.who.int/medicinedocs/en/d/Js4876e/. [Last accessed on 2017 May 7].
10. Zafar F, Ali H, Naveed S, Korai OU, Rizvi M, Naqui GR, et al. Drug utilization pattern in cardiovascular diseases: A descriptive study in tertiary care setting in Pakistan. J Bioequiv Availab 2015;7:59-62.
11. WHO- International Drug Monitoring the Role of National Centre. Geneva: Technical Report Series WHO; 1972. p. 498.
12. Kumar L. Pharmacovigilance/reporting adverse drug reactions: An approach to enhance health surveillance and extending market share by minimizing the chances of drug withdrawals. Int J Pharm Pharm Sci 2015;7:1-7.
13. Mahmoud SH, Asselberg FW, Keyser CE, Sooverein PC, Hofman A, Stricker BH, et al. Change in prescription pattern as a potential marker for adverse drug reactions of angiotensin converting enzyme inhibitors. Int J Clin Pharm 2015;37:1095-103.
14. Vakede KP, Thorat MV, Khanwelkar CC, Jadhav SA, Sanghishetti VM. A study of prescribing pattern of drugs in patients of cardiovascular emergencies at a tertiary care hospital of Western Maharashtra. Int J Res Med Sci 2016;4:556-61.
15. Barron HV, Michael AD, Maynard C, Every NR. Use of angiotensin converting enzyme inhibitors at discharge in patients with acute myocardial infarction in United States: Data form from the national registry of myocardial infarction. J Am Coll Cardiol 1998;32:360-70.
16. Gregorie F, Pariente A, Reglat AF, Haramburu F, Begaud B, Moore N. A signal of increased risk of hypoglycaemia with angiotensin receptor blocker caused by confounding. Br J Clin Pharmacol 2008;66:142-5.
17. Kumar M, Dahiya V, Mishra S, Sharma D, Mishra N, Lahkar M. Cardiovascular disease prevalence and drug utilisation pattern at a tertiary care hospital in north-eastern India. Int J Pharm Pharm Sci 2016;8:116-9.
18. Sandozi T, Nausheen F. Drug utilisation study in ischemic heart diseases associated with diabetes and hypertension. Int J Pharm Bio Sci 2010;1:1-4.
19. Baskota M, Rao BS, Shakya R. Study on the prescribing patterns of drugs used in heart failure. J Sci Eng Technol 2006;2:1-10.
20. Al-Mallah MH, Tleyeh IM, Ahamed A, Latif A, Weaver WD. Angiotensin–converting enzyme inhibitors in coronary artery disease and preserved left ventricular systolic function. J Am Coll Cardiol 2006;47:1576-83.
21. Lee HY, Cooke CE, Robertson TA. Use of secondary prevention drug therapy in patients with acute coronary syndrome after hospital discharge. J Manage Care Pharm 2008;14:271-80.
22. Nazir A, Sheikh FM, Aslam S, Javaid U. ACE inhibitors; comparison of ACE inhibitors (perindopril, ramipril and lisinopril) induced cough. Prof Med J 2016;23:1145-8.
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Sood, A., J. Joseph, S. Mathew, S. K, R. Ks, and B. Raj Kc. “A STUDY ON UTILIZATION OF ANGIOTENSIN-CONVERTING ENZYME INHIBITORS AND ANGIOTENSIN RECEPTOR BLOCKERS IN PATIENTS WITH CARDIOVASCULAR DISEASES”. Asian Journal of Pharmaceutical and Clinical Research, Vol. 11, no. 12, Dec. 2018, pp. 330-3, doi:10.22159/ajpcr.2018.v11i12.27974.
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