Title: Efficacy of newer versus older antihypertensive drugs in black patients living in sub-Saharan Africa
Authors: M'buyamba-Kabangu, J R
Anisiuba, B C
Ndiaye, M B
Lemogoum, D
Jacobs, Lotte
Ijoma, C K
Thijs, Lutgarde
Boombhi, H J
Kaptue, J
Kolo, P M
Mipinda, J B
Osakwe, C E
Odili, A
Ezeala-Adikaibe, B
Kingue, S
Omotoso, B A
Ba, S A
Ulasi, I I
Staessen, Jan A # ×
Issue Date: Dec-2013
Publisher: Scientific & Medical, Macmillan Press
Series Title: Journal of Human Hypertension vol:27 issue:12 pages:729-35
Article number: 10.1038/jhh.2013.56
Abstract: 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.Journal of Human Hypertension advance online publication, 27 June 2013; doi:10.1038/jhh.2013.56.
ISSN: 0950-9240
Publication status: published
KU Leuven publication type: IT
Appears in Collections:Hypertension and Cardiovascular Epidemiology
× corresponding author
# (joint) last author

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