: In last 2 decades, there have been substantial changes in the utilization patterns
of antihypertensive medicines following new clinical trials and the introduction of new treatment
guidelines. The aim of this study was to analyze utilization and prescribing patterns regarding
antihypertensive medicines in the Republic of Srpska, Bosnia and Herzegovina during an 11-
years follow-up according to national and European treatment guidelines.
Methods: In this retrospective, observational study, medicine utilization data were
analyzed between 2009–2019 period using the ATC/DDD methodology and expressed
as the number of DDD/1,000 inhabitants/day (DID/TID). The medicine utilization 90%
(DU90%) method was used for determine the quality of prescribing.
Results: During the observed period, the use of antihypertensive medicines increased more
than 3-times (125.97 DDD/TID in 2009 vs 414.95 DDD/TID in 2019), corresponding to a rise
in the prevalence of hypertensive patients from 91.7/1,000 to 186.3/1,000 in the same
period. This was mainly driven by increased use of angiotensin converting enzyme inhibitors
with 241.69%, beta blockers with 146.87%, calcium channel blockers with 251.55%, and
diuretics with 178.95%. Angiotensin receptor blockers were the fastest growing group of
antihypertensive medicines in this period and their utilization increased nearly 40 times.
Conclusions: The overall antihypertensive medicines utilization was largely influenced by
national and ESH/ESC guidelines and strongly corresponded to the positive medicine list
of the national health insurance fund. Antihypertensive medicines utilization is comparable
with medicine utilization trends in other countries.
Keywords: antihypertensive medicines, medicine utilisation, ATC/DDD analyses, n
