JNC 8 Guideline Adherence and Systolic Blood Pressure Outcomes: Real-world Evidence from Sri Lanka
DOI:
https://doi.org/10.32350/cpr.41.06Keywords:
blood pressure control, hypertension, Joint National Committee guidelines, prescribing patterns, primary care, Sri LankaAbstract
Hypertension is a leading cause of cardiovascular morbidity globally, including Sri Lanka. Data on prescribing pattern adherence to Joint National Committee (JNC 8) guidelines in Sri Lankan primary care remains limited. The aim of this study was to evaluate antihypertensive prescribing patterns according to JNC 8 guidelines. Furthermore, the study also intended to assess Blood Pressure (BP) control among hypertensive patients at a primary care hospital in Kandy, Sri Lanka. A retrospective cross-sectional study was conducted among 411 hypertensive patients attending the primary care hospital, Ududumbara, Kandy, Sri Lanka, using prescription records abstracted over a one-month period (November 2025). Prescribing patterns were assessed against JNC 8 criteria using a structured data collection tool. JNC 8 guideline adherence was found to be high at 92%. Most patients (59.4%) received combination therapy. The most commonly prescribed drug classes were Angiotensin Receptor Blockers (ARBs) and diuretics. Systolic Blood Pressure (SBP) control was achieved in 82.7% of patients. Diabetes mellitus was identified as an independent predictor of poor BP control (OR = 0.504, 95% CI: 0.293–0.847, p = 0.012). This study revealed high adherence to JNC 8 prescribing guidelines. Additionally, the study also discovered that SBP control was achieved in most patients, though nearly one-fifth remained uncontrolled within the recommended targets in this rural Sri Lankan population. The association between diabetes and BP control highlights the need for intensified treatment strategies. As a retrospective cross-sectional analysis, these associations should not be interpreted as causal. Health systems should complement prescriber education with patient-centered interventions and expedited protocols for diabetic hypertensives.
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Copyright (c) 2026 Zainab Razeen, Fawas Hakeem, Yumna Fouzer, Hasna Faris , Ali Akhtar, Hazmath Shakeenah, Waqas Akram
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