Randomized, interventional, prospective, comparative study to evaluate the antihypertensive efficacy and tolerability of ramipril versus telmisartan in stage 1 hypertensive patients with diabetes mellitus

Pankaj Kumar, A. Kapoor, H. K. Singh, Malini Kulshrestha
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引用次数: 2

Abstract

Angiotensin converting enzyme inhibitors and angiotensin receptor blockers are keystones for therapy of hypertension in diabetes because they show favourable effects on diabetic nephropathy and cardiovascular disease outcomes. A prospective, randomized, interventional clinical study of one year duration was conducted to comparatively evaluate anti-hypertensive efficacy and tolerability profile of ramipril versus telmisartan in stage 1 hypertensive patients associated with type 2 diabetes mellitus, amongst patients of either sex attending the medicine OPD of Rohilkhand Medical College and Hospital, Bareilly. Clearance from institutional ethical committee and written informed consent of the participants was taken. The enrolled 222 patients were randomized into ramipril and telmisartan groups, of these only 192 patients completed the study. The data obtained were statistically analyzed by paired and unpaired t-test using SPSS software. Prevalence of hypertension in diabetics was more in 41 to 50 years age group, in females (male: female ratio= 0.92:1) and in rural areas (rural: urban ratio= 0.61:1). Baseline BP values were equally matched in both groups. The SBP and DBP were reduced from baseline in all the ten follow-ups and were statistically significant (p <0.0001 for both groups). Regarding adverse effects, both drugs were well tolerated though dry irritating cough and dizziness was more in ramipril group. Both ramipril and telmisartan as monotherapy were equally effective in lowering SBP and DBP on prolonged use in diabetic hypertensives but the incidence of adverse effects was higher with ramipril hence telmisartan be preferred. KEY WORDS : Ramipril; Telmisartan; Systolic; Diastolic blood pressure; Stage 1 hypertensive patients; Diabetes mellitus
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随机、介入性、前瞻性、比较研究评价雷米普利与替米沙坦对1期高血压合并糖尿病患者的降压疗效和耐受性
血管紧张素转换酶抑制剂和血管紧张素受体阻滞剂是治疗糖尿病高血压的关键,因为它们对糖尿病肾病和心血管疾病的预后有良好的影响。一项为期一年的前瞻性、随机、干预性临床研究,比较评价雷米普利与替米沙坦在2型糖尿病合并1期高血压患者中的降压疗效和耐受性,研究对象为在巴雷利罗希尔坎德医学院和医院内科门诊就诊的男女患者。获得了机构伦理委员会的批准和参与者的书面知情同意。纳入的222例患者被随机分为雷米普利组和替米沙坦组,其中只有192例患者完成了研究。所得资料采用SPSS软件进行配对和非配对t检验进行统计学分析。糖尿病患者高血压患病率在41 ~ 50岁年龄组、女性(男女比= 0.92:1)和农村地区(城乡比= 0.61:1)较高。两组的基线血压值相等。在所有10次随访中,收缩压和舒张压均较基线降低,且具有统计学意义(两组均p <0.0001)。在不良反应方面,两种药物均耐受良好,但雷米普利组的干咳、头晕较多。长期使用雷米普利和替米沙坦单药治疗糖尿病高血压患者,降低收缩压和舒张压的效果相同,但雷米普利的不良反应发生率较高,因此首选替米沙坦。关键词:雷米普利;替米沙坦;收缩压;舒张压;1期高血压患者;糖尿病
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