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The efficacy of hydrochlorothiazide, timolol and enalapril in Ethiopians with essential hypertension.

A double-blind trial of hydrochlorothiazide, timolol and enalapril was carried out in Ethiopians with essential hypertension at the Tikur Anbessa Hospital, Addis Abeba, between 1987 and 1990. Patients with a supine diastolic blood pleasure of 95-120 mmHg after a washout period of 2 weeks were randomized to receive hydrochlorothiazide 25 mg daily, timolol 10 mg daily or enalapril 10 mg daily. Doses were doubled at 4 weeks if the diastolic blood pressure remained above 95 mmHg. At the end of 8 weeks of treatment, there were 9 patients taking hydrochlorothiazide, 10 patients taking timolol and 7 patients taking enalapril. Hydrochlorothiazide significantly lowered both systolic and diastolic blood pressure at 4 and 8 weeks compared with pre-treatment levels. Timolol and enalapril did not significantly lower the systolic blood pressure, but each lowered the diastolic blood pressure at 4 weeks and 8 weeks respectively. More patients on hydrochlorothiazide attained a diastolic blood pressure of less than 90 mmHg while less patients required doubling of dosage compared to timolol and enalapril. It is concluded that Ethiopian hypertensives may respond better to diuretics than to beta-blockers or angiotensin converting enzyme inhibitors, as found in other black populations.