Effects of Thiazide Diuretic in Combination with Amiloride versus Hydrochlorothiazide Alone, on Plasma Glucose and Electrolytes in Hypertensive Nigerians: A Community Based Study

Background: Diuretics are known to be the most effective antihypertensive medicines in Black Africans and people of African origin. Hydrochlorothiazide (HCT) and Amiloride-HCT(Amiloride combined with-Hydrochlorothiazide (Amiloride-HCT) used either as a single medicine or in combination with other antihypertensive medicines, are the two diuretics commonly used in the management of high blood pressure in Nigeria.

Aim: The present study aimed at comparing the metabolic effects of the Hydrochlorothiazide (HCT) and Amiloride-HCT in Nigerian hypertensive population.

Methods: Participants who gave their consent were recruited through a community based hypertension screening programme. One hundred newly diagnosed hypertensive patients aged 30 -70 years were recruited and randomly assigned to use either Amiloride-HCT or HCT. A cohort of two groups of patients consisting of 50 patients per group was studied. Each group of patient was followed up for a period of 6 weeks after commencing diuretic antihypertensive medicines. Fasting plasma glucose, serum electrolytes and lipids were assessed at baseline and at two (2) weeks interval after commencing antihypertensive therapy.

Results: HCT and Amiloride-HCT significantly reduced blood pressure in mild to moderate hypertension after six (6) weeks of treatment and this reduction was similar in the two groups. Although, moduretic appears to have more pronounced effect on K+, Ca2+ and HDL-C, this metabolic effect was not significantly different from the observed pattern in HCT group.

Conclusions: Amiloride-HCT and HCT commonly used in the management of hypertension in Nigeria remain effective and achieve similar reduction in blood pressure. They both also cause similar derangement in metabolic profile in the newly diagnosed hypertensive subjects at least in the short-term.