ABSTRACT
Background: Current treatment guidelines for treatment of hypertension stipulate the use of diuretics or calcium channel blockers (CCBs) as first-line treatment. Although, many studies have been carried out to study prescription pattern and blood pressure (BP) control in this region none has independently compared the effect of different antihypertensive drug classes given as monotherapy on BP control. This study compares the BP lowering efficacy of different classes of antihypertensive drugs given as monotherapy in black hypertensive patients with or without complications. Methods: This prospective cross-sectional study evaluated the influence of antihypertensive prescription on BP controls among consecutive patients present on clinic days from November 2011 to April 2012. Patients were treated with either angiotensin-converting enzyme inhibitor, angiotensin receptor blocker, beta-blocker, CCB, centrally acting adrenergic drug or diuretic. The primary outcome was BP reading <140/90 mmHg in patients without complication or <130/80 mmHg in patients with complication. Results: Of 264 patients, 228 patients received one drug whereas 36 received no drug. More than half of those on non-pharmacological intervention had good BP control (n=21), patients on diuretic (28.8%) had a significantly higher BP control (p=0.014) than those on other classes of drugs. Only 58% of the patients had good BP control. Diastolic BP reduced with an increase in age. Conclusions: In this study, diuretics significantly reduced BP compared with other antihypertensive class. Although clinical trials also suggest the use of CCB as first‑line treatment, cost considerations are necessary.
ABSTRACT
BACKGROUND & OBJECTIVES: Anaemia is commonly observed in children with malaria, but reports on leucocyte and platelet count abnormalities associated with malaria are inconsistent. This study examined the effect of age, gender, parasite density and temperature on haematological parameters in children with acute uncomplicated malaria. METHODS: Haematological parameters were determined in children with acute uncomplicated malaria, and these were correlated with age, sex, temperature and parasite density. Statistical analysis was done using SAS 9.1. RESULTS: Six hundred and ninety five children with acute uncomplicated malaria participated in the study. The mean age was 51.7 months +/- 33.8. At presentation, anaemia occurred in 43.8% of the patients and children <5 yr had a significantly lower haematocrit (28.4% +/- 4.8) than that of older children (32.8% +/- 4.8) (p <0.001), but the haematocrit was not significantly different by days 14 and 28. There was no difference between both sexes. Leucocytosis was more frequently seen than leucopenia (9.5% vs 3%). Thrombocytopenia was found in 59.3% of enrolled patients. More than half of the patients with thrombocytopenia had recovered by Day 28. Baseline platelet count was related to Day 14 (r = 0.6, p < 0.0001) and Day 28 (r = 0.2, p = 0.0015) and the haematocrit on Day 28 (r = 0.12, p = 0.00197). Platelet count showed no correlation with temperature, parasite density and leucocyte count. Haematocrit correlated with age (r = 0.4, p < 0.0001); but not with parasite density or temperature. Leucocyte count showed no correlation with age or parasite density. CONCLUSION: While thrombocytopenia was the most common haematological finding and may be of diagnostic importance, anaemia and leucocytosis were more common in the under fives.