POSTMARKETING SURVEILLANCE (PHARMACOVIGILANCE) OF ANTIHYPERTENSIVE DRUGS BETWEEN 1981 AND 1990 IN A TEACHING HOSPITAL

The eighties were characterized by the introduction of angiotensin con verting enzyme inhibitors (ACEI) and calcium channel blockers (CCB) in the treatment of arterial hypertension. The present study investigate s the side effects of antihypertensive drugs in the Toulouse Universit y Hospital (France) between 1981 and 1990. Most of the side effects in volved ACEI (45 %), CCB (22 %) and diuretics (18 %). Central antihyper tensive agents and beta-blocking drugs were involved in 8 and 9 % of s ide effects respectively. During these 10 years, 197 side effects were reported in our hospital (3300 beds). Some of them were found more fr equently: renal insufficiency (15 %) or cough (9 %) with ACEI, constip ation (3 %), gingivitis (1 %) or lower limb oedema (4.5 %) with CCB, h emolytic or autoimmune anemia (2.5 %) and confusional state (1.5 %) wi th central antihypertensive agents, nightmares (1.5 %) with propranolo l. The most frequently side effects were dermatological (20 %), hydroe lectrolytic (10 %) and neuropsychiatric (9.6 %) disturbances. In spite of the methodological problems of this kind of study (retrospective e valuation, under-notification of the side effects and different scores of imputability), these data indicate the most frequently observed si de effects of antihypertensive agents during the eighties. It allows t o estimate an approximate frequency of these side effects : among the antihypertensive drugs, CCB and diuretics seems the less frequently in volved in the occurrence of reported side effects.