Hypertension requires appropriate pharmacological therapy to achieve blood pressure control and prevent complications. In geriatric patients, physiological changes and comorbidities may increase the risk of inappropriate therapy and adverse drug reactions. Objective: This study aimed to evaluate the rationality of antihypertensive drug use among geriatric patients based on the appropriateness of indication, patient, drug selection, dosage, and the occurrence of adverse drug reactions at the Inpatient Unit of Sembiring Deli Tua General Hospital. Methods: This was a non-experimental study with a retrospective descriptive design using medical record data from 30 geriatric patients with hypertension who were hospitalized in 2025. The rationality of antihypertensive drug use was evaluated based on the criteria of appropriate indication, patient, drug selection, and dosage, referring to the JNC 8 guideline. Data were analyzed descriptively using frequency distributions and percentages. Results: The appropriateness of indication was 86.6%, patient selection 100%, drug selection 76.6%, and dosage 83.3%. All patients (100%) were recorded as experiencing adverse drug reactions during antihypertensive therapy. Most patients were female (63.3%) and aged 56–65 years (66.6%). Conclusion: Antihypertensive drug use among geriatric patients generally met most criteria for rational drug use, particularly the appropriateness of patient selection. However, inappropriate indications, drug selection, and dosage, as well as the high occurrence of adverse drug reactions, were still identified. Regular therapeutic evaluation and monitoring of drug use are therefore necessary to improve the safety and effectiveness of antihypertensive therapy in geriatric patients.
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