Ademola Aderibigbe

Rationale and design of the Newer Versus Older Antihypertensive Agents in African Hypertensive Patients (NOAAH) trial

Abstract Background. Sub-Saharan Africa experiences an epidemic surge in hypertension. Studies in African Americans led to the recommendation to initiate antihypertensive treatment in Blacks with a diuretic or a low-dose fixed combination including a diuretic. We mounted the Newer versus Older Antihypertensive Agents in African Hypertensive Patients (NOAAH) trial to compare in native African patients a fixed combination of newer drugs, not involving a diuretic, with a combination of older drugs including a diuretic. Methods. Patients aged 30–69 years with uncomplicated hypertension (140–179/90–109 mmHg) and two or fewer associated risk factors are eligible. After a 4-week run-in period off treatment, 180 patients will be randomized to once daily bisoprolol/hydrochlorothiazide 5/6.25 mg or amlodipine/valsartan 5/160 mg. To attain and maintain blood pressure below 140/90 mmHg during 6 months of follow-up, the doses of bisoprolol and amlodipine in the combination tablets will be increased to 10 mg/day with the possible addition of α-methyldopa or hydralazine. NOAAH is powered to demonstrate a 5-mmHg between-group difference in sitting systolic pressure with a two-sided p-value of 0.01 and 90% power. NOAAH is investigator-led and complies with the Helsinki declaration. Results. Six centers in four sub-Saharan countries started patient recruitment on September 1, 2010. On December 1, 195 patients were screened, 171 were enrolled, and 51 were randomized and followed up. The trial will be completed in the third quarter of 2011. Conclusions. NOAAH (NCT01030458) is the first randomized multicenter trial of antihypertensive medications in hypertensive patients born and living in sub-Saharan Africa.

Usefulness of renal length and volume by ultrasound in determining severity of chronic kidney disease

To determine the correlation of renal ultrasonic parameters and degree of kidney function among chronic kidney disease patients seen at the Nephrology unit of the University of Ilorin Teaching Hospital (UITH) Ilorin, we studied 322 patients. The results were analyzed with specific reference to socio-demography and correlating renal length and volume with estimated glomerular filtration rate. The male to female ratio was 2:1, with an age range from 20 to 80 years and mean age of 45.06 (±13.0) years. The serum creatinine levels ranged from 201 to 1205 μmol/L, with a mean of 388 ± 168 μmol/L, while the estimated glomerular filtration rate (eGFR) ranged from 3.77 to 44.32 mL/min, with a mean of 18.2 ± 7.19 mL/min. The right and left renal lengths ranged from 6.9 to 13.0 cm, with a mean of 9.11 ± 1.06, and 6.5-13.4 cm, with a mean of 9.23 ± 1.07 cm, respectively. The mean volumes of the right and left kidneys were 98.6 ± 41.9 cm 3 and 105 ± 46.2 cm 3 , respectively. The Pearson correlation of the right and left kidneys length to eGFR were -0.197 and -0.137 respectively, while that of the right and left kidney volume to eGFR were -0.122 and -0.043, respectively. Our study showed that there is a positive correlation between ultrasonic renal measurements and degree of kidney function.