Blood Pressure Control Following Fixed-dose Combination Antihypertensive Therapy in a Private Nigerian Cardiology Setting: A Retrospective Descriptive Study
Tosin Majekodunmi
Department of Cardiology, Euracare Multi-Specialist Hospital, Lagos, Nigeria.
Moses C. Nnamdi *
Department of Clinical Research, Majek Medical Services, Lagos, Nigeria.
Ebubechukwu Ezeh
Department of Cardiovascular Medicine, University of Kansas, Kansas, United States.
Nzekwe Joy Ijeoma
Department of Quality and Patient Safety, Euracare Multi-Specialist Hospital, Lagos, Nigeria.
Amina Rabiu
College of Medicine, Gulf Medical University, Ajman, United Arab Emirates.
*Author to whom correspondence should be addressed.
Abstract
Background: Hypertension is a leading modifiable risk factor for cardiovascular morbidity and mortality, with a disproportionate burden in low- and middle-income countries, including Nigeria. Questions remain regarding real-world prescribing patterns, blood pressure responses, and follow-up control rates among patients receiving combination antihypertensive therapy in Nigerian private clinical settings.
Aim: To evaluate antihypertensive prescribing patterns, blood pressure changes, control rates, and documented treatment-related adverse events among patients with hypertension managed at a private multispecialist hospital in Lagos, Nigeria.
Methods: A retrospective observational study was conducted among 563 adults with hypertension who had baseline and second-visit blood pressure measurements; 286 also had third-visit measurements. Demographic characteristics, comorbidities, treatment regimens, and blood pressure outcomes were analysed. Paired-samples t-tests were used to compare mean systolic and diastolic blood pressures across visits, while independent-samples t-tests and chi-square tests were used to compare patients who completed and did not complete follow-up. A p-value <0.05 was considered statistically significant.
Results: The cohort had a mean age of 60.23 ± 14.12 years and was predominantly male (57.73%). Significant reductions in systolic blood pressure were observed, with mean decreases of 21.09 mmHg and 28.53 mmHg at the second and third visits, respectively (p < 0.001). Among patients with available follow-up blood pressure measurements, mean systolic blood pressure decreased significantly from baseline to the second visit and from baseline to the third visit. Blood pressure control was achieved in 219/563 patients at the second visit and 172/286 patients at the third visit.
Conclusion: Antihypertensive therapy, particularly commonly used combination regimens, was associated with significant reductions in blood pressure and improved control rates across follow-up visits in this private Nigerian clinical setting. Prospective studies are needed to confirm the effectiveness, adherence benefits, and safety of fixed-dose combination therapy in broader Nigerian populations.
Keywords: Hypertension, blood pressure control, fixed-dose combination therapy, antihypertensive therapy, cardiovascular risk.