Blood Pressure Control Following Fixed-dose Combination Antihypertensive Therapy in a Private Nigerian Cardiology Setting: A Retrospective Descriptive Study

Abstract

Background: Hypertension is a leading modifiable risk factor for cardiovascular morbidity and mortality, with a disproportionate burden in low- and middle-income countries, including Nigeria. Questions remain regarding real-world prescribing patterns, blood pressure responses, and follow-up control rates among patients receiving combination antihypertensive therapy in Nigerian private clinical settings. Aim: To evaluate antihypertensive prescribing patterns, blood pressure changes, control rates, and documented treatment-related adverse events among patients with hypertension managed at a private multispecialist hospital in Lagos, Nigeria. Methods: A retrospective observational study was conducted among 563 adults with hypertension who had baseline and second-visit blood pressure measurements; 286 also had third-visit measurements. Demographic characteristics, comorbidities, treatment regimens, and blood pressure outcomes were analysed. Paired-samples t-tests were used to compare mean systolic and diastolic blood pressures across visits, while independent-samples t-tests and chi-square tests were used to compare patients who completed and did not complete follow-up. A p-value <0.05 was considered statistically significant. Results: The cohort had a mean age of 60.23 ± 14.12 years and was predominantly male (57.73%). Significant reductions in systolic blood pressure were observed, with mean decreases of 21.09 mmHg and 28.53 mmHg at the second and third visits, respectively (p < 0.001). Among patients with available follow-up blood pressure measurements, mean systolic blood pressure decreased significantly from baseline to the second visit and from baseline to the third visit. Blood pressure control was achieved in 219/563 patients at the second visit and 172/286 patients at the third visit. Conclusion: Antihypertensive therapy, particularly commonly used combination regimens, was associated with significant reductions in blood pressure and improved control rates across follow-up visits in this private Nigerian clinical setting. Prospective studies are needed to confirm the effectiveness, adherence benefits, and safety of fixed-dose combination therapy in broader Nigerian populations.