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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
Efficacy of newer versus older antihypertensive drugs in black patients living in sub-Saharan Africa
Journal of Human Hypertension, Volume 27, No. 12, Year 2013
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Description
To address the epidemic of hypertension in blacks born and living in sub-Saharan Africa, we compared in a randomised clinical trial (NCT01030458) single-pill combinations of old and new antihypertensive drugs in patients (30-69 years) with uncomplicated hypertension (140-179/90-109 mm Hg). After ≥4 weeks off treatment, 183 of 294 screened patients were assigned to once daily bisoprolol/hydrochlorothiazide 5/6.25 mg (n=89; R) or amlodipine/valsartan 5/160 mg (n=94; E) and followed up for 6 months. To control blood pressure (<140/<90 mm Hg), bisoprolol and amlodipine could be doubled (10 mg per day) and α-methyldopa (0.5-2 g per day) added. Sitting blood pressure fell by 19.5/12.0 mm Hg in R patients and by 24.8/13.2 mm Hg in E patients and heart rate decreased by 9.7 beats per minute in R patients with no change in E patients (-0.2 beats per minute). The between-group differences (R minus E) were 5.2 mm Hg (P<0.0001) systolic, 1.3 mm Hg (P=0.12) diastolic, and 9.6 beats per minute (P<0.0001). In 57 R and 67 E patients with data available at all visits, these estimates were 5.5 mm Hg (P<0.0001) systolic, 1.8 mm Hg (P=0.07) diastolic and 9.8 beats per minute (P<0.0001). In R compared with E patients, 45 vs 37% (P=0.13) proceeded to the higher dose of randomised treatment and 33 vs 9% (P<0.0001) had α-methyldopa added. There were no between-group differences in symptoms except for ankle oedema in E patients (P=0.012). In conclusion, new compared with old drugs lowered systolic blood pressure more and therefore controlled hypertension better in native African black patients. © 2013 Macmillan Publishers Limited. All rights reserved.
Available Materials
https://efashare.b-cdn.net/share/pmc/articles/PMC3831294/bin/jhh201356x1.doc
Authors & Co-Authors
M'Buyamba-Kabangu, Jean René
Belgium, Leuven
Departement Cardiovasculaire Wetenschappen
Congo, Leuven
University Hospital of Kinshasa
Anisiuba, Benedict Chukwuemeka
Nigeria, Naukka
University of Nigeria
Ndiaye, Mouhamadou Bamba
Senegal, Dakar
Centre Hospitalier Universitaire Dakar
Lemogoum, Daniel
Cameroon, Douala
Douala School of Medicine
Jacobs, Lotte
Belgium, Leuven
Departement Cardiovasculaire Wetenschappen
Ijoma, Chinwuba K.
Nigeria, Naukka
University of Nigeria
Thijs, Lutgarde B.
Belgium, Leuven
Departement Cardiovasculaire Wetenschappen
Boombhi, Hilaire J.
Cameroon, Yaounde
Yaounde General Hospital
Kaptue, Joseph
Cameroon, Douala
Douala School of Medicine
Kolo, Phillip Manma
Nigeria, Ilorin
University of Ilorin
Mipinda, Jean Bruno
Gabon, Libreville
Centre Hospitalier de Libreville
Osakwe, C. E.
Nigeria, Wuse
National Biotechnology Development Agency, Nigeria
Odili, Augustine Nonso
Belgium, Leuven
Departement Cardiovasculaire Wetenschappen
Nigeria, Abuja
University of Abuja
Ezeala-Adikaibe, Birinus
Nigeria, Naukka
University of Nigeria
Kingue, Samuel
Cameroon, Yaounde
Yaounde General Hospital
Omotoso, Babatunde A.
Nigeria, Ilorin
University of Ilorin
Bâ, Serigne Abdou
Senegal, Dakar
Centre Hospitalier Universitaire Dakar
Ulasi, Ifeoma I.
Nigeria, Naukka
University of Nigeria
Staessen, Jan A.
Belgium, Leuven
Departement Cardiovasculaire Wetenschappen
Netherlands, Maastricht
Universiteit Maastricht
Statistics
Citations: 19
Authors: 19
Affiliations: 11
Identifiers
Doi:
10.1038/jhh.2013.56
e-ISSN:
14765527
Research Areas
Noncommunicable Diseases