Abstract

Background: Hypertension (HTN) is a challenging public health problem and a major contributing factor to cardiovascular diseases with high mortality. In most African countries and Cameroon in particular, HTN is the most common non-communicable disease.

In Cameroon, the prevalence of HTN spans from 5.7% in rural settings through 21.9% in semi urban to 47.5% in urban milieu, with a national average survey of 29.7%. Several drugs of different chemical classes are used in the treatment of hypertension. But some of these drugs prescribed may induce liver injury. Therefore, this study sought to ascertain the relationship between antihypertensive drugs and liver enzymes among hypertensive patients in order to provide data to improve on the management of hypertension.

Methods: A cross sectional study was carried out from the months of February to May 2022 at Buea Regional Hospital. A total of 75 consenting hypertensive patients aged 21-60 years old both male and female were selected in a convenient manner. Socio-demographic data of participants were obtained using a structured questionnaire while clinical data was obtained from the clinician. Serum levels of liver enzymes were measured for the 75 participants using a spectrophotometer based on their kinetic methods. Data obtained was analyzed using descriptive statistics, a Chi-square test was used to test for association where appropriate and a P-value <0.05 was considered statistically significant.

Results: Of the 75 participants enrolled in the study, 54(72%) were females while 21(28%) were males. The mean (SD) age was 52(7) years ranging from 32-60 years. Mean systolic blood pressure (SBP) was 146mmHg and mean diastolic blood pressure (DBP) was 82mmHg. Only 34.7% of the participants had their mean blood pressure controlled (BP <140/90mmHg). More than half of the study participants had normal serum levels of liver enzymes that is about 92% for alanine aminotransferase (ALT), 64% for aspartate aminotransferase (AST) and 90% for alkaline phosphatase (ALP).

Chi-squared test revealed that ALT and ALP showed a significant association with the side effects of the participants (p < 0.05 and p < 0.001, respectively). ALP showed a significant positive association with the type of antihypertensive drug and complications of HTN (p <0.005 and p <0.003, respectively). ALT was significantly associated with daily-dose frequency of the participants (p <0.05). AST showed a significant positive association with blood pressure (p <0.03).  All liver enzymes showed no significant association with age, gender, marital status, occupational status, BMI and duration of treatment (p >0.05).

Conclusion: From this study, most classes of antihypertensive drugs do not produce adverse effect in the liver based on liver enzymes measurement except for ALP which was positively associated with the type of antihypertensive drug particularly calcium channel blockers.

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