From 2004 to 2007, in our hospital, the analysis of antihypertensive drugs showed that ARBs (angiotensin receptor blockers) ranked at the top among antihypertensive drugs and have become an indispensable medication. The sales volume ranked after calcium channel blockers, which is consistent with the usage trend of ARBs. These drugs can effectively reduce plasma angiotensin II levels, mitigate various pathophysiological effects induced by it, and block the renin-angiotensin system more completely than ACE inhibitors without causing adverse reactions such as coughing. Although ARBs are more expensive, their antihypertensive effects are significant, contraindications and side effects are fewer, leading to higher patient compliance. Irbesartan, as a representative drug, ranks high in both sales volume and DDDs (Defined Daily Doses).
ACE inhibitors lower blood pressure by inhibiting the formation of angiotensin II, can inhibit cardiovascular tissue remodeling, and exhibit antihypertensive efficacy along with renal protective effects. They are the preferred drugs for hypertensive patients accompanied by heart failure and diabetic nephropathy. However, due to adverse reactions like dry cough, their sales growth rate has shown a declining trend.
Beta-adrenergic receptor blockers lower blood pressure through mechanisms such as slowing heart rate, decreasing myocardial contractility, reducing cardiac output, and lowering plasma renin activity. Their antihypertensive effect is weaker and onset time longer, mainly used for mild to moderate hypertension, often combined with calcium channel blockers. Metoprolol, as a representative drug, ranked sixth or seventh in sales volume over four years and first in frequency of use from 2005 to 2007. The sorting of pharmaceutical sales volume and DDDs indicates reasonable drug usage.
As shown in Table 4, the sales volume and usage quantity of antihypertensive drugs in our hospital are basically synchronous and indicate reasonable medication. Among them, drugs with serial numbers >1 indicate higher application frequency and lower sale prices, such as metoprolol. Drugs with serial numbers <1 indicate underrepresented applications and higher sale prices, such as amlodipine. Our hospital's antihypertensive drugs meet the needs of patients at different levels, achieving effective and economical use.
In summary, the use of antihypertensive drugs in our hospital is basically rational. The total sales volume and variety increase year by year. Calcium channel blockers, angiotensin receptor blockers, and angiotensin-converting enzyme inhibitors are currently the main drugs in treating hypertension, demonstrating the advantages of long-lasting antihypertensive effects and protection of target organs such as the heart, brain, kidney, and vessels. Due to individual differences in patients and varying characteristics of antihypertensive effects, doctors should fully consider these factors before treatment and develop different dosing regimens for different patients to achieve the goal of rational drug use and ensure patients receive high-quality treatment.