Abstract
Recent guidelines have suggested combination therapy as initial treatment in hypertensive patients with ≥ grade 2 hypertension, aiming to achieve target blood pressure (BP) goal faster and more effectively. Both calcium channel blockers (CCBs) and angiotensin converting enzyme inhibitors (ACEIs) are in the list of first-line antihypertensives, however the choice of the combination therapy is left to the discretion of the clinician, and there are concerns that ACEIs are less effective in BP reduction among black hypertensives.
Highlights
Hypertension is a disease of public health importance worldwide, including Tanzania
Both Amlodipine and Lisinopril each in combination with Bendroflumethiazide showed impressive blood pressure (BP) reductions in this cohort of native Tanzanian patients with ≥ stage 2 hypertension, and there was an insignificant difference between them. Both drug combinations can be used in the initial treatment plan when the priority is to reduce one’s BP
We aimed to study the level of BP reduction of commonly prescribed drugs in Tanzania; Lisinopril and Amlodipine, each in combination with Bendroflumethiazide in patients with moderate to severe hypertension being followed-up in hypertension clinics in 3 district hospitals in Dar es Salaam
Summary
Hypertension is a disease of public health importance worldwide, including Tanzania. In Tanzania, hypertension is present in 25.9% among 25-64 years-old adults [1], and it is an underlying cardiovascular risk factor in 14.6% and 45% of general internal medicine and cardiology patients, respectively [2,3]. There has been an increase in recorded cardiovascular and renal complications including stroke, left ventricular hypertrophy, heart failure, chronic kidney disease and cardiovascular deaths in the country [2,3,5,6,7]; a trend that has been seen in other parts of the sub Saharan Africa region [8] To overcome this trend, better BP control remains one of the most important priorities, as it is the most significant intervention to reduce complications. Better BP control remains one of the most important priorities, as it is the most significant intervention to reduce complications This task is faced with many challenges including lack of simple, cheap and readily available evidence-informed drug combinations to control hypertension in the local setting. We aimed to study the BP lowering effect after 4 weeks of treatment with Amlodipine (CCB) and Lisinopril (ACEI) each in combination with Bendroflumethiazide (thiazide diuretic) among adult hypertensive patients with ≥ grade 2 hypertension attending 3 district hospitals in Dar-es-Salaam, Tanzania
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