Use of Antihypertensive Medications in Patients with Type-2 Diabetes in Ajman, UAE

  • Mohammed Arifulla Department of Pharmacology, Gulf Medical University, Ajman, UAE.
  • Lisha Jenny John Mail Department of Pharmacology, Gulf Medical University, Ajman, UAE.
  • Jayadevan Sreedharan Department of Statistics, School of Statistical Support, Gulf Medical University, Ajman, UAE.
  • Jayakumary Muttappallymyalil Department of Community Medicine, Gulf Medical University, Ajman, UAE.
  • Jenny Cheriathu Department of Pediatrics, Gulf Medical University, Ajman, UAE.
  • Sheikh Altaf Basha Department of Internal Medicine, Gulf Medical College Hospital, Ajman, UAE.
Anti-hypertensives, Diabetes, Drug utilization


Optimal reduction in blood pressure with antihypertensive agents helps to prevent microvascular and macrovascular complications of diabetes. The objective of the study was to evaluate the current utilization pattern of antihypertensive medications among patients with diabetes and coexistent hypertension as per the JNC seventh report guidelines. A Cross-sectional survey was conducted among patients with diabetes attending outpatient department of Internal Medicine at a hospital at Ajman. Medical records of patients were used to obtain diagnostic, demographic and drug use information. Univariate analysis was performed using Chi-square and t- test followed by logistic regression to compute independent predictors. Of 132 patients with diabetes, uncomplicated hypertension (HTN) was coexistent in 81% (107/132) of patients. Males constituted 49.5% (53/107) of the total. Mean (SD) age of patients with HTN was 55.1(10.1) years higher than those without HTN 49.6 (9.9) years (P5 years (P=0.04). While adjusting the significant factors, only duration of diabetes was statistically significant (adjusted OR=1.06; CI 95% (1.003-1.116) P= 0.03 among patients with HTN. 63.6% (68/107) prescriptions contained one drug antihypertensive drug, 27.1 % (29/107) two drugs and 7.4% (8/107) no anti-hypertensive drug were prescribed. Angiotensin converting enzyme inhibitors/ Angiotensin receptor blockers (ACEI/ARBs) followed by diuretics were commonly prescribed drugs. ARBs with diuretics were the most frequent two drug combinations. The antihypertensive utilization pattern was similar in both gender and age groups. Results represent the current prescribing trend for anti-hypertensive agents among patients with diabetes that is in accordance with JNC-7 recommendations.


Diabetes program: Country and regional data. World Health Organization. (Accessed in April 2014, 14, at diabetes/facts/world_figures/en/).

Malik M, Bakir A, Abi Saab B, et al. Glucose intolerance and associated factors in the multi-ethnic population of the United Arab Emirates: results of a national survey. Diabetes Res Clin Pr 2005;69(2):188-95.

Adler AI, Neil HA, Manley SE, et al. Hyperglycemia and hyperinsulinemia at diagnosis of diabetes and their association with subsequent cardiovascular disease in the United Kingdom prospective diabetes study (UKPDS 47). Am Heart J 1999;138(5Pt 1):S353-9.

Al-Maskari F, El-Sadig M, Norman JN. The prevalence of macrovascular complications among diabetic patients in the United Arab Emirates. Cardiovasc Diabetol 2007;6(1):24.

Garber AJ. Attenuating Cardiovascular Risk Factors in Patients with Type 2 Diabetes. Am Fam Physician 2000;62(12):2645-6.

Chobanian AV, Bakris GL, Black HR, et al. Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. National Heart, Lung, and Blood Institute; National High Blood Pressure Education Program Coordinating Committee. Seventh report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. Hypertension 2003;42(6):1206-52

Johnson ML, Singh H. Patterns of Antihypertensive Therapy Among Patients with Diabetes J Gen Intern Med 2005;20(9):842-6.

Sweileh WM, Sawalha AF, Zyoud SH, et al. Evaluation of antihypertensive therapy in diabetic hypertensive patients: impact of ischemic heart disease. Pharmacy Practice (Granada) 2009;7(1):40-6.

Al Khaja KA, Sequeira RP, Mathur VS, et al. Family physicians' and general practitioners' approaches to drug management of diabetic hypertension in primary care. J Eval Clin Pract 2002;8(1):19-30.

Yusuf S, Sleight P, Pogue J, et al. Effects of an angiotensin-converting-enzyme inhibitor, ramipril, on cardiovascular events in high-risk patients. The heart outcomes prevention evaluation study investigators. N Engl J Med 2000;342(3:)145-53.

Deedwania PC. Diabetes and hypertension, the deadly duet: importance, therapeutic strategy, and selection of drug therapy. Cardiol Clin 2005;23(2):139-52.

Kalra S, Kalra B, Agrawal N. Combination therapy in hypertension: An update. Diabetol Metab Syndr 2010;2(1):44.

ALLHAT Officers and Coordinators for the ALLHAT Collaborative Research Group. The Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial. Major outcomes in high-risk hypertensive patients randomized to angiotensin-converting enzyme inhibitor or calcium channel blocker vs diuretic: The Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT). JAMA 2002;288(23):2981-2997.

Efficacy and safety of fixed combination of perindopril and indapamide in type 2 diabetes: results from ADVANCE in context of available evidence. J Hypertens. 2008;26(Suppl 3):23S-30S.

Neutel JM, Franklin SS, Oparil S, et al. Efficacy and safety of irbesartan/HcTZ combination therapy as initial treatment for rapid control of severe hypertension. J Clin Hypertens (Greenwich) 2006;8(12):850-7.

How to Cite
Arifulla M, John LJ, Sreedharan J, Muttappallymyalil J, Cheriathu J, Altaf Basha S. Use of Antihypertensive Medications in Patients with Type-2 Diabetes in Ajman, UAE. Acta Med Iran. 53(2):129-133.