A Comparative Study of Adverse Events Experienced by Hypertensive Type 2 Diabetic Nigerians during Initiation of Treatment with Amlodipine or Hydrochlorothiazide

Although amlodipine (AML) and hydrochlorothiazide (HCZ) have been recommended by various Hypertension Writing Groups to initiate antihypertensive therapy, it has not yet been properly investigated whether AML or HCZ would demonstrate a safer adverse events profile. This chapter aims to evaluate whether AML or HCZ would be preferable for treating hypertensive type 2 diabetic Nigerians by comparing the adverse events profiles of the 2 drugs. Forty male (M) and female (F) newly diagnosed hypertensive subjects with controlled type 2 diabetic mellitus (T2DM) aged 43-68 years were randomized to AML and HCZ treatment groups of 20 patients each (10 Ms, 10 Fs), and they were treated respectively, with AML 10mg and HCZ 25mg, both drugs being given once daily for 48 weeks. Each subject had their body mass index (BMI) calculated. The following measurements were made: baseline, weeks 1, 3, 6, 12, 24, 36, and 48. Blood pressure (BP), heart rate (HR), and 24-hour urine volume. Additionally, from week 1 to week 48, adverse event profiles were recorded. The findings showed that The drugs significantly reduced BP, though the effect of AML was significantly greater compared to that of HCZ (P<0.01). Diuresis was significant in HCZ group (P<0.01). There were 48 adverse events (48.5%) in the AML group including weight loss and mild tachycardia. No patient had peripheral pedal edema. The majority of the 51 occurrences (51.5%) in the HCZ group were weight loss, moderate tachycardia, polyuria, myalgia/cramps, impotence, and visual impairment. Despite the fact that both medications seemed to be well tolerated, AML showed a higher ability to decrease blood pressure and had a lower incidence of side effects. In diabetic Nigerian patients with essential hypertension, it is preferable to utilise medications that provide effective blood pressure management and carry the lowest possible risk of side effects, such as AML.