Hypertension control in Kerala, India: a prescription-based study

A prescription-based study was conducted to identify the provider and institution-level factors related to achieving guideline-recommended control of hypertension and diabetes mellitus in the state of Kerala.

The cross-sectional study in primary and secondary care hospitals in Kerala included both public and private institutions. One practitioner was selected from each institution. Prescriptions were photographically captured and data on disease status and drugs prescribed were recorded. Totally 4679 prescriptions were included for analysis.

For hypertension-only patients, control levels were 31.5% and was significantly higher in public hospitals.

Among patients with diabetes only, diabetes control was seen in 36.6%. When both conditions were present, control was achieved in only 17.0% patients.

Being prescribed two or more drugs indicated lower control.

Hence,In this prescription-based study in Kerala, a majority of hypertensive patients did not have controlled blood pressure levels, particularly if diabetes coexisted. This has serious implication as Kerala is the state with the highest burden of hypertension in India.