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Experience with Common Anti-hypertensives Regarding Development of Impaired Glycaemia in a Specialised Primary Care Facility in Jos, Nigeria

Received: 31 October 2021     Accepted: 22 November 2021     Published: 2 December 2021
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Abstract

Hypertension (HBP) and diabetes (DM) co-exist with worse outcomes. Various hypotheses explain this, one of which is the drug used to treat HBP. One therefore sought to see what drug (s) have this potential and under what conditions they manifest. This is to guide future practice, and reduce morbidity. Consequently, hypertensives attending this specialized primary care facility who had no diabetes, recent ischaemic phenomenon and not in heart failure were studied with blood glucose as outcome measure. Basic clinico-demographic data and information related to the HBP were collected. A total of 210 hypertensives seen over the study period satisfied enrolment criteria; out of whom 108 were females. Mean age was 56.42 (10.46) with a span of 31 to 88 years. Most of them were middle aged. HBP history ranged from 5 to 240 months; with a mean of 71.74 (53.35). Their mean (SD) FBG when first seen in the clinic was 5.10 mmol/l (0.94) which marginally rose to 5.20 mmol/l (0.85) by the time of the study. The glucose was more likely to rise in females (p=0.013), with longstanding HBP (p=0.000), use of beta blockers/diuretic (p=0.014), co-administration of statins (p=0.006) and with metabolic syndrome co-morbidity (p=0.028). In conclusion, chances of developing impaired glycaemia or new onset DM with antihypertensive treatment are higher in women, family history of diabetes, longer duration of hypertension, use of beta blockers or thiazide diuretics, use of statins and presence of the metabolic syndrome. These should be considered while initiating treatment in hypertensives to avoid introducing additional risk factors.

Published in American Journal of Internal Medicine (Volume 9, Issue 6)
DOI 10.11648/j.ajim.20210906.15
Page(s) 269-272
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2021. Published by Science Publishing Group

Keywords

Diabetes, Onset, Treatment, Hypertension, Nigerian-African

References
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[2] Aksnes JA, Kjeldsen SE, Rostrup M, Storset O, Hua TA, Julim S. (2008). Predictors of new-onset Diabetes Mellitus in Hypertensive patients: The VALUE Trial. J. Hum Hypertens. 22: 520-527.
[3] Eckel RH, Grundy SM, Zimmet PZ. (2005). The metabolic syndrome. Lancet. 365 (9468): 1415-1428.
[4] Selph S, Dana T, Blazina I, Bougatsos C, Patel H, Chou R. (2015). Screening for type 2 diabetes mellitus. A systematic review for the US Preventive Services Task Force. Ann Int Med. 162 (11): 765-776.
[5] Melville NA. (2021). Specific Blood Pressure Lowering Drugs Prevent Onset of New Diabetes. Medscape. Nov 12, 2021.
[6] Basile JN. (2009). Antihypertensive therapy, new onset diabetes and cardiovascular disease. Int J Clin Pract. 63 (4): 656-666.
[7] Redon J, Cifkora R, Laurent S, on behalf of the scientific council of the European Society of Hypertension. (2008). The Metabolic Syndrome in Hypertension: European Society of Hypertension Position Statement. J Hypertens. 26: 1891-1900.
[8] Vadecchia P, Reboldi G, Angeli F, Reboldi G, Gattobigio R. (2004). Adverse prognostic significance of new diabetes in treated hypertensive subjects. Hypertens. 43: 963-969.
[9] Sarafidis PA, Bakris GC. (2006). Antihypertensive therapy and the risk of new onset diabetes. Diabetes Care. 29 (5): 1167-1169.
[10] Okafor CI. (2012). The metabolic syndrome in Africa. Current trends. Ind. J. Endocrinol Metab. 16 (1): 56-60.
[11] Price AJ, Crampin AC, Amberbir A, Kayuni-Chihana N, Musicho C, Tafatatha T et al. (2018). Prevalence of obesity, hypertension and diabetes and cascade of care in sub-Saharan Africa: a cross sectional population based study in rural and urban Malawi. Lancet Diabetes Endocrinol. 6: 208-222.
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[14] Verdecchia P, Angeli F, Reboldi G, Gattobigio R. (2006). Is the development of diabetes with antihypertensive therapy a problem? J Clin Hyp. 8 (2): 120-126.
[15] Hermida RC, Ayala DE, Mojon A, Fernandez JR. (2014). Risk of new onset diabetes: influence of class and treatment time regimen of hypertensive medications P-117. J Am Soc Hypertens. 8(48): e67-e74.
[16] Twito O, Ahron E, Jaffe A, Afele S, Cohen E, Efrat C et al. (2013). New onset diabetes in elderly subjects. Diabetes Care. 36 (11): 3425-3429.
[17] Tobe SW. (2014). Beta adrenergic receptor blockers in hypertension. Can. J Card. 30: 51-82.
[18] Stears AJ, Woods SH, Watts MM, Burton TJ, Graggaber J, Mir FA et al. (2012). A double blind placebo controlled cross-over trial comparing the effect of amiloride and hydrochlorothiazide on glucose tolerance in patients with essential hypertension. Hypertens. 59: 934-942.
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[20] Zillich AJ, Garg J, Basu S, Bakris GL, Carter DL. (2006). Thiazide Diuretics, Potassium and the Development of Diabetes: A Qualitative Review. Hypertens. 48: 219-224.
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  • APA Style

    Basil Nwaneri Okeahialam. (2021). Experience with Common Anti-hypertensives Regarding Development of Impaired Glycaemia in a Specialised Primary Care Facility in Jos, Nigeria. American Journal of Internal Medicine, 9(6), 269-272. https://doi.org/10.11648/j.ajim.20210906.15

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    ACS Style

    Basil Nwaneri Okeahialam. Experience with Common Anti-hypertensives Regarding Development of Impaired Glycaemia in a Specialised Primary Care Facility in Jos, Nigeria. Am. J. Intern. Med. 2021, 9(6), 269-272. doi: 10.11648/j.ajim.20210906.15

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    AMA Style

    Basil Nwaneri Okeahialam. Experience with Common Anti-hypertensives Regarding Development of Impaired Glycaemia in a Specialised Primary Care Facility in Jos, Nigeria. Am J Intern Med. 2021;9(6):269-272. doi: 10.11648/j.ajim.20210906.15

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  • @article{10.11648/j.ajim.20210906.15,
      author = {Basil Nwaneri Okeahialam},
      title = {Experience with Common Anti-hypertensives Regarding Development of Impaired Glycaemia in a Specialised Primary Care Facility in Jos, Nigeria},
      journal = {American Journal of Internal Medicine},
      volume = {9},
      number = {6},
      pages = {269-272},
      doi = {10.11648/j.ajim.20210906.15},
      url = {https://doi.org/10.11648/j.ajim.20210906.15},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ajim.20210906.15},
      abstract = {Hypertension (HBP) and diabetes (DM) co-exist with worse outcomes. Various hypotheses explain this, one of which is the drug used to treat HBP. One therefore sought to see what drug (s) have this potential and under what conditions they manifest. This is to guide future practice, and reduce morbidity. Consequently, hypertensives attending this specialized primary care facility who had no diabetes, recent ischaemic phenomenon and not in heart failure were studied with blood glucose as outcome measure. Basic clinico-demographic data and information related to the HBP were collected. A total of 210 hypertensives seen over the study period satisfied enrolment criteria; out of whom 108 were females. Mean age was 56.42 (10.46) with a span of 31 to 88 years. Most of them were middle aged. HBP history ranged from 5 to 240 months; with a mean of 71.74 (53.35). Their mean (SD) FBG when first seen in the clinic was 5.10 mmol/l (0.94) which marginally rose to 5.20 mmol/l (0.85) by the time of the study. The glucose was more likely to rise in females (p=0.013), with longstanding HBP (p=0.000), use of beta blockers/diuretic (p=0.014), co-administration of statins (p=0.006) and with metabolic syndrome co-morbidity (p=0.028). In conclusion, chances of developing impaired glycaemia or new onset DM with antihypertensive treatment are higher in women, family history of diabetes, longer duration of hypertension, use of beta blockers or thiazide diuretics, use of statins and presence of the metabolic syndrome. These should be considered while initiating treatment in hypertensives to avoid introducing additional risk factors.},
     year = {2021}
    }
    

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  • TY  - JOUR
    T1  - Experience with Common Anti-hypertensives Regarding Development of Impaired Glycaemia in a Specialised Primary Care Facility in Jos, Nigeria
    AU  - Basil Nwaneri Okeahialam
    Y1  - 2021/12/02
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    AB  - Hypertension (HBP) and diabetes (DM) co-exist with worse outcomes. Various hypotheses explain this, one of which is the drug used to treat HBP. One therefore sought to see what drug (s) have this potential and under what conditions they manifest. This is to guide future practice, and reduce morbidity. Consequently, hypertensives attending this specialized primary care facility who had no diabetes, recent ischaemic phenomenon and not in heart failure were studied with blood glucose as outcome measure. Basic clinico-demographic data and information related to the HBP were collected. A total of 210 hypertensives seen over the study period satisfied enrolment criteria; out of whom 108 were females. Mean age was 56.42 (10.46) with a span of 31 to 88 years. Most of them were middle aged. HBP history ranged from 5 to 240 months; with a mean of 71.74 (53.35). Their mean (SD) FBG when first seen in the clinic was 5.10 mmol/l (0.94) which marginally rose to 5.20 mmol/l (0.85) by the time of the study. The glucose was more likely to rise in females (p=0.013), with longstanding HBP (p=0.000), use of beta blockers/diuretic (p=0.014), co-administration of statins (p=0.006) and with metabolic syndrome co-morbidity (p=0.028). In conclusion, chances of developing impaired glycaemia or new onset DM with antihypertensive treatment are higher in women, family history of diabetes, longer duration of hypertension, use of beta blockers or thiazide diuretics, use of statins and presence of the metabolic syndrome. These should be considered while initiating treatment in hypertensives to avoid introducing additional risk factors.
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Author Information
  • Cardiology Sub-Unit 1, Department of Medicine, Jos University Teaching Hospital, Jos, Nigeria

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