Suitability of Drug Prescribing Patterns in Patients with Hypertension Conditions Based on the AHA/ACC 2025 Hypertension Guideline

Abstract

Hypertension or high blood pressure is a global health challenge dubbed the silent killer because of the risk of fatal complications in target organs if not managed properly. This study aimed to analyse prescribing patterns and the correlation between patient characteristics (blood pressure and comorbidity categories) and the accuracy of drug selection and dosage, in accordance with the AHA/ACC 2025 Hypertension Guidelines, at Tjipluk Clinic, Probolinggo. The method used was observational analysis with a retrospective design. Sampling was conducted using the total sampling technique, and 39 patients who met the criteria were identified from medical records in 2025. The data were analysed univariately and bivariately using Fisher's Exact Test. The results showed that 97.4% of patients were in the category of stage 2 hypertension. The accuracy rate of drug selection is low, only 28.2%, caused by monotherapy use in stage 2 patients who should receive combination therapy according to standards. In contrast, dosage accuracy yielded 89.7%. Bivariate analysis revealed no significant relationship between blood pressure category or comorbidities with drug selection accuracy (p=1,000). However, there was a significant relationship between comorbidities and drug dose accuracy (p=0.003), suggesting that comorbidities add to the difficulty in determining the appropriate dose. In conclusion, the prescribing pattern at the research site is not fully aligned with international guidelines because it relies on outdated standards. Periodic evaluation and updates of clinical guidelines for healthcare workers are required to improve therapeutic effectiveness and patient safety.