Observations on the Use of Low-Dose Hydrochlorothiazide in the Treatment of Hypertension in Diabetic Nigerians

Objective: The effects of low doses of hydrochlorothiazide (HCTZ) and amiloride in a fixed-combination formulation on blood pressure (BP), serum K⁺ and diabetic control were assessed in 11 adult Nigerians with hypertension and type 2 diabetes for 12 weeks. Methods: The study included concurrent exposure to 75 mg of aspirin daily by mouth and dietary advice not to add table salt to regular meals, initiated 4 weeks prior to HCTZ therapy. Results: The addition of 12.5 mg of HCTZ resulted in a significantly lower BP, which was evident within 4 weeks. There was no significant variation in serum K⁺, Na⁺, creatinine or body weight or the need to alter the dose of hypoglycaemic agents. An initial rise in fasting blood sugar (FBS) after 4 weeks of HCTZ therapy was evident but subsequent rises were not significantly different to the initial rise in FBS observed at week 4. Conclusions: These observations are preliminary and would need longer-term follow-up and treatment of a larger number of patients for confirmation, but they do have the potential to lead to a cheaper and safer therapeutic approach to effective control of BP in diabetic Nigerians with hypertension.