Comparison of the Efficacy and Tolerability of Candesartan Cilexetil between Hypertension patients of Muna and Tolaki Ethnicity

Abstract

There are differences in the efficacy of a drug between ethnicities. Hypertension Treatment Guidelines of JNC 8 recommend not using angiotensin receptor blockers (ARBs) and ACE inhibitors in the black population for first-line therapy. The Tolaki and Muna ethnicities are two indigenous ethnic groups of the Southeast Sulawesi Province of Indonesia. The very different physical characteristics between these two ethnic groups raise the possibility that there are differences in the body's response to antihypertensive ARBs, including candesartan. The study aimed to compare the efficacy and tolerability of candesartan cilexetil monotherapy for one month in hypertensive patients of the Tolaki and Muna ethnicities. Assessment of therapy efficacy includes the proportion of patients achieving the therapeutic target according to JNC 8 and the reduction of blood pressure. Tolerability is assessed based on side effects and adverse drug reactions (ADR) reported by patients. Patients who met the criteria for this study were those who had recently been diagnosed with essential hypertension or hypertension with type 2 diabetes mellitus, were taking candesartan cilexetil (8 mg orally once a day), and had blood pressure values after one month of treatment. Sixty-eight Tolaki ethnic patients and 51 Muna ethnic patients who met the inclusion criteria were included in this study. The results showed that the decrease in systolic and diastolic blood pressure was greater in the Tolaki than those in the Muna ethnicity. The median value of the systolic decrease was -33 ((-10)–(-60)) mmHg for the Tolaki ethnic group and -10 (0–(-20)) mmHg for the Muna ethnic group. The median value of diastolic decline for the Tolaki and Muna ethnicities was -10 (0–(-37)) mmHg and -5 (5–(-20)) mmHg, respectively. The MAP value of the Tolaki ethnic group is 93.30 (80–110), and that of the Muna ethnic group is 110 (96.69–130). The achievement of the target of reducing blood pressure was also significantly higher for the Tolaki than the Muna ethnicities. Complaints felt by some people in both ethnic groups were dizziness, headaches, and feeling weak. Six people in the Muna ethnic group with diabetes mellitus with type 2 experienced hyperkalemia. There was a significant difference in the efficacy of candesartan for one month between Muna and Tolaki ethnic hypertension patients. There was no difference in tolerability between the two ethnic groups.