Observations on the Use of Low-Dose Hydrochlorothiazide in the Treatment of Hypertension in Diabetic Nigerians

Abstract

Objective: The effects of low doses of hydrochlorothiazide (HCTZ) and amiloride in a fixed-combination formulation on blood pressure (BP), serum K⁺ and diabetic control were assessed in 11 adult Nigerians with hypertension and type 2 diabetes for 12 weeks. Methods: The study included concurrent exposure to 75 mg of aspirin daily by mouth and dietary advice not to add table salt to regular meals, initiated 4 weeks prior to HCTZ therapy. Results: The addition of 12.5 mg of HCTZ resulted in a significantly lower BP, which was evident within 4 weeks. There was no significant variation in serum K⁺, Na⁺, creatinine or body weight or the need to alter the dose of hypoglycaemic agents. An initial rise in fasting blood sugar (FBS) after 4 weeks of HCTZ therapy was evident but subsequent rises were not significantly different to the initial rise in FBS observed at week 4. Conclusions: These observations are preliminary and would need longer-term follow-up and treatment of a larger number of patients for confirmation, but they do have the potential to lead to a cheaper and safer therapeutic approach to effective control of BP in diabetic Nigerians with hypertension.

Type 2 diabetes and hearing loss in black Africans*

“…This study was undertaken in a University hospital diabetic clinic, as described previously [4,5]. Essentially, adults with Type 2 diabetes, regularly attending our clinic for at least 12 months were approached to volunteer after detailed explanations of the procedures involved and the time commitment required.…”

“…Most of these studies, however, involved mixed populations of Type 1 and Type 2 diabetes in Europeans and Americans with hardly any information on hearing function in indigenous Africans with diabetes. For these reasons, we investigated hearing in a group of Nigerians with Type 2 diabetes, as Type 1 disease is uncommon in black Africans [4–6].…”

Influence of West African Ethnicity and Gender on Beta-Cell Function and Insulin Sensitivity in Essential Hypertensives Treated with Hydrochlorothiazide and Hydrochlorothiazide-lisinopril Combination

“…A similar potassium change was found by both Okoro et al [15] and Adigun et al [16] who used HCT to treat hypertension. Studies in which higher doses of up to 50 mg of HCT was employed as monotherapy in hypertensives similarly showed the percentage change in plasma potassium of 4.9%.…”

“…A similar potassium change was found by both Okoro et al . [ 15 ] and Adigun et al . [ 16 ] who used HCT to treat hypertension.…”

Aspirin and Diabetes Care in Nigeria: Treatment or Exploitation?

“…This can stimulate demand and expand customer base for this indication in the wider population but what is not often mentioned is that the types of stroke and heart conditions that commonly occur in Nigeria are rarely due to occlusive atherosclerosis but almost invariably result from uncontrolled blood pressure in over 90% of cases and this is usually in those with hypertension and or type 2 diabetes [3,4,[49][50][51][52][53][54][55]. At the current price of five naira per tablet per day, this amount can pay for up to five days of antihypertensive therapy with low dose thiazide diuretics which is capable of lowering blood pressure to targets that optimally diminish the risk of untimely deaths and other cardiovascular events particularly in many black people, at least initially [39,90,91]. Five naira, equivalent to about ten US cents [by current exchange rate of 197 naira to one US dollar] may not seem much by purchasing power available in many high income countries, but over a lifetime of treatment, this can mean a lot of money for many struggling Nigerians, majority of who are poor and disproportionately affected by hypertension and type 2 diabetes [20,30 ].…”