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Efficacy of newer versus older antihypertensive drugs in black patients living in sub-Saharan Africa.


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 ?-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 ?-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.

SUBMITTER: M'Buyamba-Kabangu JR 

PROVIDER: S-EPMC3831294 | biostudies-literature | 2013 Dec

REPOSITORIES: biostudies-literature

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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  ...[more]

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