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Research Article Open access CC BY 3.0

Effects of Initiating Antihypertensive Therapy with Amlodipine or Hydrochlorothiazide on Creatinine Clearance in Hypertensive Nigerians with Type 2 Diabetes Mellitus

Godfrey B.S. Iyalomhe, Eric K.I. Omogbai, Osigbemhe O.B. Iyalomhe, Sarah I. Iyalomhe

Biotechnology Journal International · pp. 79–89 · Published 9 Jan 2013

10.9734/BBJ/2013/2456

Abstract

Aims: To assess the effects of initiating antihypertensive therapy with amlodipine (AML) or hydrochlorothiazide (HCZ) for 48 weeks on creatinine clearance (Clcr) in hypertensive Nigerians with type 2 diabetes mellitus (DM). Study Design: Randomized, open-label, prospective, outpatient study. Place and Duration of Study: Department of Pharmacology and Therapeutics, College of Medicine, Ambrose Alli University, Ekpoma, Edo State, Nigeria between March 2008 and March 2009. Methodology: We randomized 40 newly diagnosed hypertensive subjects with controlled type 2 diabetes mellitus (DM) aged 43-68 years to AML and HCZ treatment groups of 20 patients each (20 males (M) and 20 females (F)) and they were treated monotherapeutically, respectively, with AML 10mg and HCZ 25mg, all given once daily for 48 weeks. Body mass index (BMI), blood pressure (BP), 24h urine volume, urine creatinine, serum creatinine and the corresponding Clcr for each day were evaluated at baseline before treatment and at the end of weeks 1, 3, 6, 12, 24, 36 and 48 during treatment. Results: The 2 drugs significantly reduced BP and at week 48, the mean M vs F systolic BP (SBP)/Diastolic BP (DBP) decrease from baseline for AML group (27.0/17.5 vs 29.5/20.0 mmHg) was more significant than that of HCZ group (23.5/17.5 vs 22.0/16.5 mmHg, P < .01). HCZ caused maximum M vs F diuresis (1593.00 +/- 27.21 vs 1587.00 +/- 30.60 ml) at week 3 and this was significantly higher than that (1526.00 +/- 27.10 vs 1516.00 +/- 22.76 ml, P < .01) produced by AML. Although the treatment effect exerted by the 2 drugs on Clcr was significant (P =.05), time-dependent changes in the mean values, which were higher in AML group, were not significantly different. Conclusion: It is demonstrated that in hypertensive Nigerians with type 2 DM, single daily doses of these medications do not have a clinically significant effect on Clcr over a long-term monotherapy. Accordingly, with regard to HCZ greater diuresis which may cause problems particularly in the elderly, AML appears to be a preferred logical alternative to substitute for low dose HCZ therapy.

Amlodipine and hydrochlorothiazide antihypertensive therapy creatinine clearance type 2 diabetes mellitus Nigerians

References (31)

  1. 1 The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure The JNC 7 Report [DOI]
  2. 2 Recommendations for Blood Pressure Measurement in Humans and Experimental Animals [DOI]
  3. 3 Development and progression of nephropathy in type 2 diabetes: The United Kingdom Prospective Diabetes Study (UKPDS 64) [DOI]
  4. 4 Diabetes, Hypertension, and Cardiovascular Disease [DOI]
  5. 5 Incident diabetes in clinical trials of antihypertensive drugs: a network meta-analysis [DOI]
  6. 6 Preventing Microalbuminuria in Type 2 Diabetes [DOI]
  7. 7 Effects of Calcium-Channel Blockade in Older Patients with Diabetes and Systolic Hypertension [DOI]
  8. 8 Nephropathy in Patients with Type 2 Diabetes [DOI]
  9. 9 Renal outcomes with different fixed-dose combination therapies in patients with hypertension at high risk for cardiovascular events (ACCOMPLISH): a prespecified secondary analysis of a randomised controlled trial [DOI]
  10. 10 Methods in clinical chemistry
  11. 11 Risk factors for development of incipient and overt diabetic nephropathy in patients with non-insulin dependent diabetes mellitus: prospective, observational study [DOI]
  12. 12 The Biological Concept of Race and Its Application to Public Health and Epidemiology [DOI]
  13. 13 Systematic Review: Antihypertensive Drug Therapy in Black Patients [DOI]
  14. 14 Therapeutic benefits of ACE inhibitors and other antihypertensive drugs in patients with type 2 diabetes. [DOI]
  15. 15 Follow-up of renal function in treated and untreated older patients with isolated systolic hypertension [DOI]
  16. 16 Clinical Significance of Renal Function in Hypertensive Patients at High Risk [DOI]
  17. 17 Thiazide-induced subtle renal injury not observed in states of equivalent hypokalemia [DOI]
  18. 18 Abnormal Laboratory Results: Creatinine clearance and the assessment of renal function [DOI]
  19. 19 Current Epidemiology of Hypertension in Nigeria [DOI]
  20. 20 Thiazide diuretics enhance nocturnal blood pressure fall and reduce proteinuria in immunoglobulin A nephropathy treated with angiotensin II modulators [DOI]
  21. 21 Hydrochlorothiazide: is it a wise choice? [DOI]
  22. 22 Discussion [DOI]
  23. 23 Antihypertensive treatment and new-onset diabetes mellitus [DOI]
  24. 24 Management of Hypertension in Diabetic Patients With Chronic Kidney Disease [DOI]
  25. 25 Management of Hypertension in Diabetes [DOI]
  26. 26 Effect of Diuretic Drugs on Creatinine Clearance Determination [DOI]
  27. 27 Calcium channel blockers and the kidney [DOI]
  28. 28 Is population-wide diuretic use directly associated with the incidence of end-stage renal disease in the united states? [DOI]
  29. 29 Monitoring renal function in hypertension [DOI]
  30. 30 Management of Hypertension with Special Emphasis on Nigeria [DOI]
  31. 31 Re: Hawkins RG, Houston MC Is population-wide diuretic use directly associated with the incidence of end-stage renal disease in the United States? A hypothesis. Am J Hypertens. 2005 Jun;18(6):744-9 [DOI]

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