Practice of Indian Physicians Towards Use of Calcium Channel Blockers in the Management of Hypertension : A Paper Based Questionnaire Survey.

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dc.contributor.authorDalvi, Kalpesh
dc.contributor.authorPatel, Kamlesh
dc.contributor.authorTrailokya, Abhijit
dc.date.accessioned2015-04-21T08:19:51Z
dc.date.available2015-04-21T08:19:51Z
dc.date.issued2015-01
dc.description.abstractHypertension is a prevalent condition. Improving blood pressure control would depend on understanding concerns and limitations of physicians. Objective: Understanding practice of calcium channel blockers use among physicians. Material and methods: A cross-sectional, observational paper based questionnaire survey among 218 Indian physicians. Results: According to 55.83% of physicians (n=218), prevalence of hypertension ranges between 21-40%. Sixty percent physicians get referred cases mostly from the general physicians (69.48%). More than 20% patients have concomitant illness according to 33.81% physicians, most common being diabetes (33.44%).According to 96.30% physicians, due to asymptomatic nature, hypertension remains undiagnosed, untreated and uncontrolled. Stress (32.35%), obesity (23.13%), physical inactivity (22.78%) and smoking (20.52%) are responsible for sympathetic over activity. Calcium channel blockers (CCBs) (37.19%), beta blockers (30.43%), angiotensin receptor blocker (ARB) (12.14%) and angiotensin converting enzyme (ACE) inhibitors (4.02%) are used as first choice in patients with sympathetic over activity. Ischemic event, stroke, heart failure and renal failure occur due to ignoring sympathetic over activity according to 30.91%, 25.39%, 20.97% and 22.30% physicians respectively. According to 51.63% of physicians, patient compliance to antihypertensive therapy is > 70%. Lack of awareness (40.5%) and dosage frequency (24%) are two most common reasons for noncompliance. According to 89.72% of physicians, the current CCBs primarily inhibit L-type calcium channels but cause sympathetic over activity. A total of 48.34% physicians, >10% patients complain of pedal edema with amlodipine. In physicians opinion, blockage of L and N type of calcium channels (56.47%), unique mode of action (11.76%), arteriolar and venous dilation (9.41%) and inhibition of reninangiotensin- aldosterone (RAS) system (7.06%) are responsible for less pedal edema with cilnidipine. A total of 98.7% and 99.54% physicians rated efficacy and safety of cilnidipine as “good-very good” compared to other CCB respectively. Conclusion: In hypertension, sympathetic over activity may cause many complications. As per the physicians opinion survey, cilnidipine because of its unique mechanism of action offers multiple benefits in hypertensive patients and can be preferred over amlodipine.en_US
dc.identifier.citationDalvi Kalpesh, Patel Kamlesh, Trailokya Abhijit. Practice of Indian Physicians Towards Use of Calcium Channel Blockers in the Management of Hypertension : A Paper Based Questionnaire Survey. Indian Medical Gazette. 2015 Jan ; 149 (1): 34-39.en_US
dc.identifier.urihttps://imsear.searo.who.int/handle/123456789/157699
dc.language.isoenen_US
dc.source.urihttps://medind.nic.in/ice/t15/i1/icet15i1p34.pdfen_US
dc.subjecthypertensionen_US
dc.subjectsympathetic over activityen_US
dc.subjectphysicians based questionnaire surveyen_US
dc.subjectQuestionnairesen_US
dc.subjectcilnidipineen_US
dc.subject.meshAdult
dc.subject.meshBlood Pressure --physiology
dc.subject.meshCalcium Channel Blockers --administration & dosage
dc.subject.meshCalcium Channel Blockers --therapeutic use
dc.subject.meshDihydropyridines --administration & dosage
dc.subject.meshDihydropyridines --analogs & derivatives
dc.subject.meshDihydropyridines --therapeutics use
dc.subject.meshHumans
dc.subject.meshHypertension --drug therapy
dc.subject.meshIndia
dc.subject.meshMiddle Aged
dc.subject.meshPhysicians
dc.subject.meshQuestionnaires
dc.subject.meshSympathetic Nervous System --physiology
dc.titlePractice of Indian Physicians Towards Use of Calcium Channel Blockers in the Management of Hypertension : A Paper Based Questionnaire Survey.en_US
dc.typeArticleen_US
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