The selection of the most appropriate therapy for hypertension remains
a controversial issue. Little information is available regarding the
prescribing patterns of antihypertensives in the primary care setting
in Israel. The use of antihypertensives in 200 patients of the Maccabi
Health Fund was, therefore, examined from April to June 1994. Sixty-f
our per cent of patients received monotherapy and 36% combination ther
apy. The most commonly prescribed medication for monotherapy were angi
otensin-converting enzyme (ACE) inhibitors (33.6%), followed by beta-b
lockers (28.1%) and calcium channel antagonists (26.6%). Diuretics wer
e prescribed to 7.0% of the community. patients. Analysis of overall d
rug utilization showed that diuretics were used in 21.5% of patients,
beta-blockers in 39.5%, calcium channel blockers in 46% and ACE inhibi
tors in 40% of patients. Despite the growing evidence of the benefits
of diuretics and beta-blockers, our results show a low utilization of
these agents in comparison to other countries. It may be speculated th
at the lack of national guidelines, the absence of utilization reviews
by third party providers as well as differences in patient population
and climate conditions may all contribute to the current prescribing
habits of physicians in the Israeli community.