Comparison of Dual Therapies for Lowering Blood Pressure in Black Africans
| dc.contributor.author | Ojji, D. B. | |
| dc.date.accessioned | 2024-10-18T00:49:03Z | |
| dc.date.available | 2024-10-18T00:49:03Z | |
| dc.date.issued | 2019-03-16 | |
| dc.description.abstract | BACKGROUND:The prevalence of hypertension among black African patients is high, and these patients usually need two or more medications for blood-pressure control. However, the most effective two-drug combination that is currently available for blood pressure control in these patients has not been established. METHODS: In this randomized, single-blind, three-group trial conducted in six countries in sub-Saharan Africa, we randomly assigned 728 black patients with uncontrolled hypertension (≥140/90 mm Hg while the patient was not being treated or taking only one antihypertensive drug) to receive a daily regimen of 5 mg of amlodipine plus 12.5 mg of hydrochlorothiazide, 5 mg of amlodipine plus 4 mg of perindopril, or 4 mg of perindopril plus 12.5 mg of hydrochlorothiazide for 2 months. Doses were then doubled (10 and 25 mg, 10 and 8 mg, and 8 and 25 mg, respectively) for an additional 4 months. The primary end point was the change in the 24-hour ambulatory systolic blood pressure between baseline and 6 months. RESULTS: The mean age of the patients was 51 years, and 63% were women. Among the 621 patients who underwent 24-hour blood-pressure monitoring at baseline and at 6 months, those receiving amlodipine plus hydrochlorothiazide and those receiving amlodipine plus perindopril had a lower 24-hour ambulatory systolic blood pressure than those receiving perindopril plus hydrochlorothiazide (between group difference in the change from baseline, −3.14 mm Hg; 95% confidence interval [CI], −5.90 to −0.38; P=0.03; and −3.00 mm Hg; 95% CI, −5.8 to −0.20; P=0.04, respectively). The difference between the group receiving amlodipine plus hydrochlorothiazide and the group receiving amlodipine plus perindopril was −0.14 mm Hg (95% CI, −2.90 to 2.61; P=0.92). Similar differential effects on office and ambulatory diastolic blood pressures, along with blood-pressure control and response rates, were apparent among the three groups. CONCLUSIONS: These findings suggest that in black patients in sub-Saharan Africa, amlodipine plus either hydrochlorothiazide or perindopril was more effective than perindopril plus hydrochlorothiazide at lowering blood pressure at 6 months. (Funded by GlaxoSmithKline Africa Noncommunicable Disease Open Lab; CREOLE Clinical Trials.gov number, NCT02742467.) | |
| dc.identifier.citation | Ojji, D.B., Mayosi, B., Francis, V., Badri, M., Cornelius, V., Smythe, W., Kramer, N., Barasa, F., Damasceno, A., Dzudie, A. and Jones, E., 2019. Comparison of dual therapies for lowering blood pressure in black Africans. New England Journal of Medicine, 380(25), pp.2429-2439. | |
| dc.identifier.uri | https://repository.uniabuja.edu.ng/handle/123456789/622 | |
| dc.title | Comparison of Dual Therapies for Lowering Blood Pressure in Black Africans | |
| dc.type | Article |