Abstract

THE USE OF ANGIOTENSIN CONVERTING ENZYME (ACE) INHIBITORS AND ANGIOTENSIN-II RECEPTOR BLOCKERS (ARB) AS MONOTHERAPY ANTIHYPERTENSIVE AGENTS IN SUDANESE PATIENTS: A PRELIMINARY STUDY ON EFFECTIVENESS AND PRESCRIBING PATTERNS

Mohamed A. Nasr*, Habab K. Elkheir, Mahmoud M.E. Mudawi

Abstract

Introduction: It is increasingly apparent that black hypertensive individuals differ substantially from their white counterparts in several important aspects. Both the prevalence and severity of hypertension are greater in blacks compared with whites, leading to risks for blacks of the secondary complications of hypertension. Patients of African ancestry as a group respond better to calcium blockers and diuretics, while the response to β-adrenergic blockade and inhibition of the angiotensin converting enzyme is attenuated. A number of studies has demonstrated that black hypertensive patients may respond differently to antihypertensive drugs especially ACE inhibitors than white hypertensive patients; therefore this study was conducted to assess the use of angiotensin converting enzyme inhibitors and angiotensin-II receptor blockers as antihypertensive agents in Sudanese population and to identify the degree of blood pressure control among patients using ACEIs and ARBs. Methodology: A case finding study was done by using pre-tested, pre-validated questionnaire. Results: Angiotensin Converting Enzyme inhibitors (ACEIs) and Angiotensin-II Receptor Blockers (ARBs) were found to be associated with controlling the diastolic blood pressure (DBP) of the patients enrolled in this study. It was found that the total number of patients controlled was 75 (79%) patients out of 95. Out of 55 of the patients who were using ARBs 39 (71%) patients were controlled and 16 (29%) patients were uncontrolled; whereas those who were using ACEIs (n=40) 36 (90%) were controlled and 4 (10%) patients were uncontrolled. Therefore ACEIs seems to be more likely to control DBP than ARBs. P-value = 0.024. Conclusion: In spite of the small sample size in this study, the study could be taken as a nucleus for the effectiveness of ACEI/ARBs as a mono therapy in controlling high blood pressure among Sudanese patients, since 79% of the population involved in the study has a controlled blood pressure.

Keywords: ACE inhibitors, ARBs, Hypertension, Black hypertensive patients.