Changes in electrolyte and lipid metabolism of hypertensive patients in Komfo Anokye Teaching hospital following the administration of anti-hypertensive drugs

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Serum levels of total cholesterol, Low density lipoproteins (LDL), high density lipoproteins (HDL), Calcium, Potassium and sodium were estimated in 140 newly diagnosed patients of essential hypertension. Serum levels of these same parameters were also estimated in an equal number of normotensives serving as control group matching age to age and sex to sex. A follow up study was done on 64 of the hypertensive patients. This study was conducted at the Komfo Anokye Teaching hospital Kumasi, with the bulk of the patients coming from within the city and its surrounding towns. Cholesterol was estimated using the enzymatic method. (Reagents constituted by bio-merioux were used). Flame emission technique (CORNING 405) was used to assay the electrolytes. The o-cresolpthalein complexone method was used to assay for calcium. Serum levels of urea and creatinine were also determined using the diacetylmonoxime and Jaffe reactions respectively. The results showed a positive correlation between Total cholesterol, LDL and age with diastolic blood pressure for both patients and control group and a weak negative correlation between serum levels of HDL and age with diastolic blood pressure. A significant difference in the level of total cholesterol between hypertensives and normotensives was observed. No statistically significant difference was observed in LDL and HDL levels between hypertensives positive correlations were demonstrated betweenserum sodium and calcium levels with diastolic blood pressure, whilst a weaker correlation existed between potassium levels and diastolic blood pressure. Thirteen out of the 140 patients studied developed renal failure with a mean sodium level of 129.77 ±2.78mmol/L. The subjects responded rapidly to the management using a combination of diuretics, sympathetic nervous acting agents; receptor blockers and vasodilators. Though their blood pressures returned to the normal base line, their cholesterol and LDL levels remained high above the norinotensive range. No significant difference was found in the serum electrolyte level between the treated hypertensives and control group. A strong positive correlation was shown between serum total cholesterol; LDL levels, and essential hypertension. A weak correlation was established for the serum electrolytes level with blood pressure, whilst an inverse correlation between diastolic blood pressure and HDL levels was established.
This thesis has been submitted in partial fulfillment of the requirements for an M.Sc. Degree in Chemical Pathology at the Department of Molecular Medicine School of Medical Sciences: University of Science and Technology, Kumasi, Ghana. 1993