Document Detail


Blood pressure response to out-patient drug treatment of hypertension in 1973-1993 at Korle-Bu Teaching Hospital, Accra, Ghana.
MedLine Citation:
PMID:  14529234     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
A retrospective audit of the first twelve months of out patient drug treatment of hypertension at the Korle-Bu Teaching Hospital during the period 1973-1993 is reported. A previous study had shown that at least 7 drug regimes were used to treat hypertension at Korle-Bu during the period. The aim of the present study was to compare the effect and efficacy of these antihypertensive drug treatment regimes on blood pressure during the first 12 months of treatment. Result of 155 (47%) case notes, which met the inclusion criteria, are presented. One month of drug treatment of hypertension significantly reduced systolic and diastolic blood pressure by 21.4 +/- 30.5 (p<0.001) and 13.8 +/- 16.5 (p<0.001) mmHg, respectively. This reduction in blood pressure was maintained to the 12th month. At 12 months, systolic and diastolic blood pressures were unchanged in 19% and 28% of patients, respectively, indicating no response to drug treatment. Recommended target blood pressure of < or = 140/90 mm Hg was achieved in only 25.6% of all patients. All drug treatment regimes significantly reduced blood pressure to a similar extent so that any differences were not statistically significant. However, the efficacy of the drug regimes differed significantly (p=0.02). It was greatest in patients treated with monotherapy with either diuretic or reserpine, intermediate with two drug combinations and least with 3 or 4 drugs. The data showed that diuretics were marginally better than reserpine as first line monotherapy. Furthermore, any diuretic based 2-drug regime was equally efficacious although a beta-blocker or methyldopa as second drug seemed favoured by the data. The addition of a third or fourth drug was counter productive as the increased number of drugs did not decrease blood pressure significantly.
Authors:
I F Adukwei Hesse
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  West African journal of medicine     Volume:  22     ISSN:  0189-160X     ISO Abbreviation:  West Afr J Med     Publication Date:  2003 Jun 
Date Detail:
Created Date:  2003-10-07     Completed Date:  2003-11-07     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  8301891     Medline TA:  West Afr J Med     Country:  Nigeria    
Other Details:
Languages:  eng     Pagination:  182-6     Citation Subset:  IM    
Affiliation:
Department of Medicine and Therapeutics, University of Ghana Medical School, P. O. Box KB 4236, Accra, Ghana.
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MeSH Terms
Descriptor/Qualifier:
Adrenergic beta-Antagonists / therapeutic use
Aged
Ambulatory Care / methods*
Antihypertensive Agents / pharmacology,  therapeutic use*
Blood Pressure / drug effects*
Diastole / drug effects
Diuretics / therapeutic use
Drug Therapy, Combination
Female
Ghana
Hospitals, Teaching
Humans
Hypertension / drug therapy*,  physiopathology
Male
Medical Audit
Methyldopa / therapeutic use
Middle Aged
Reserpine / therapeutic use
Retrospective Studies
Systole / drug effects
Treatment Outcome
Chemical
Reg. No./Substance:
0/Adrenergic beta-Antagonists; 0/Antihypertensive Agents; 0/Diuretics; 50-55-5/Reserpine; 555-30-6/Methyldopa

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