HS was a more effective antihypertensive agent than HCTZ in mild to moderate hypertensive Nigerians and did not cause electrolyte imbalance. HS showed longer duration of action compared to HCTZ and reduction in serum Na+ may be another antihypertensive mechanism of action of HS.

Objectives:The present study investigated the effects of aqueous extract of Hibiscus sabdariffa (HS) on the three basic components of renin-angiotensin-aldosterone system: Plasma renin, serum angiotensin-converting enzyme (ACE), and plasma aldosterone (PA) in mild to moderate essential hypertensive Nigerians and compared with that of lisinopril, an ACE inhibitor.Materials and Methods:A double-blind controlled randomized clinical study was used. Seventy-eight newly diagnosed but untreated mild to moderate hypertensive subjects attending Medical Outpatients Clinic of Enugu State University Teaching Hospital, Enugu were recruited for the study. Those in Group A received placebo (150 mg/kg/day), Group B were given lisinopril (10 mg once daily) while those in Group C received aqueous extract of HS (150 mg/kg/day). After 4 weeks of treatment, the levels of plasma renin, serum ACE, and PA were determined.Results:HS and lisinopril significantly (P < 0.001) reduced PA compared to placebo by 32.06% and 30.01%, respectively. Their effects on serum ACE and plasma renin activity (PRA) were not significant compared to placebo; they reduced ACE by 6.63% and 5.67% but increased plasma PRA by 2.77% and 5.36%, respectively.Conclusion:HS reduced serum ACE and PA in mild to moderate hypertensive Nigerians with equal efficacy as lisinopril. These actions are possibly due to the presence of anthocyanins in the extract.

Purpose To determine the prevalence of active convulsive epilepsy and treatment gap in two Urban slums in Enugu South East Nigeria. Methods A 3 phase cross-sectional descriptive study was done to survey individuals ≥15 years in 2 slums in Enugu, South East Nigeria. Results The prevalence of epilepsy was 6.0 (95% CI: 5.9–6.0) per 1000 (men 4.4/1000, 95% CI: 2.3–6.4, women 7.8/1000, 95% CI: 4.9–10.4), p = 0.06. The peak age of active convulsive epilepsy was 40–44 years (11.2 per 1000) with two smaller peaks at 25–29 and ≥50 years. The age and sex adjusted prevalence using WHO standard population and 2006 Nigerian census population were 5.9 per 1000 (95% CI: 4.0–7.9) and 5.4 per 1000 (95% CI: 3.4–7.4). Conclusion The prevalence of epilepsy is high in urban slums in Enugu. Nationwide studies should be done to find out the true prevalence in the country.

Hibiscus sabdariffa (HS) has been traditionally used as a herbal medicine in Nigeria mainly because of its antihypertensive action. In view of the recent increase in the prevalence of renal failure, we have investigated the effect of HS consumption on renal function in Nigerians with mild to moderate hypertension. A total of 78 newly diagnosed but untreated subjects with mild to moderate hypertension attending the medical outpatients unit of Enugu State University Teaching Hospital (Enugu, Nigeria) were recruited for the study. These subjects were randomly divided into three equally sized groups that received HS or lisinopril (treatment groups) or placebo (control group), once daily for 4 weeks. Indices of renal function (urine volume and creatinine clearance) were measured at baseline and weekly throughout the study period. HS and lisinopril significantly increased (P < 0.001) urine volume compared to placebo, and HS significantly (P < 0.001) increased urine volume more than lisinopril. HS significantly increased (P < 0.001) creatinine clearance compared to placebo whereas lisinopril did not. These results indicate that HS consumption improved indices of renal function in our study population of Nigerians with mild to moderate hypertension.

Background: Despite the rising prevalence of diabetes in Nigeria and sub-Saharan Africa, few studies have assessed the prevalence of prediabetes and diabetes in people with low socioeconomic status or urban slums. Methods: Using the WHO STEP-wise approach to surveillance of noncommunicable diseases, we estimated the prevalence of diabetes and prediabetes among adults 20 years and older living in two urban slums in Enugu south east Nigeria. Diabetes was defined as previous history of diabetes, use of hypoglycemic agents and fasting blood glucose within the diabetes range on two occasions during the survey period. Study duration was 5 months. Results: Out of the 811 individuals invited to the clinic, 605 (74.6%) participants had their fasting blood glucose measured based on the study protocol. The prevalence of diabetes and prediabetes in the population was 11.7% (95% CI; 9.2-14.3) and 7.6% (95% CI; 5.0-9.7) respectively. About 54.9% were newly detected and 28.1% of them had normal control. The prevalence of diabetes peaked at 55-64 years. The odds ratio for diabetes was significantly higher in participants ≥ 45 years (1.033, 95% CI; 1.208-3.420), participants with hypertension (0.442, 95% CI; 0.257-0.762) and stroke (1.638, 95% CI; 0.459-5.848). Conclusion: There is a relatively high prevalence of diabetes among adults in two urban slums in Enugu. Public health educational measures promoting prevention and early detection of diabetes should be encouraged. Efforts should be made to educate the populace on the need for early detection and treatment.