Comparative Study to Evaluate Efficacy, Safety and Quality of Life of Metoprolol and Telmisartan versus Metoprolol and Ramipril in Patients of Hypertension
Background: Hypertension(HTN) is a major cardiovascular disease and is a major worldwide clinical problem. The prevalence of hypertension increases in urban and rural areas. The treatment of hypertension began in the 1960s with oral diuretics. The other modalities of treatment of hypertension are beta – blockers, calcium-channel blockers, alphareceptors blockers, ACE inhibitors and ARBs. The better compliance occurs with single-pill combination, and may be even double or even triple pill combination therapy should be used. Also quality of life was improved better with Metoprolol and Telmisartan as compared with Metoprolol and Ramipril. Quality of life was assessed by SF -36 Quiestionnare. Objective: To compare the effect of Metoprolol and Telmisartan versus Metoprolol and Ramipril on BP and quality of life in patients of hypertension. Material and Methods: In this prospective, open, randomized, parallel group, comparative study, 80 patients of hypertension attending the Cardiology Outpatient Department, Govt. Medical College & Rajindra Hospital, Patiala were recruited. This randomized comparative study was done on 80 patients for 4 months. Quality of Life: In my project of Quality of life, I had taken total 80 patients and the patients were divided into two groups and 40 patients each of Metoprolol and Ramipril versus Metoprolol and Telmisartan. To assess quality of life questionnaire SF-36 was administered to the patients. Results: There was a marked decrease in SBP and DBP with the use of Metoprolol and Telmisartan than Metoprolol and Ramipril. There was also no change in demographic parameters. There was significant improvement in the quality of life with Metoprolol and Telmisartan. Conclusion: Metoprolol and Telmisartan was a better choice than Metoprolol and Ramipril in treating hypertension as this combination causes more reduction in BP and little effect on HR.
Benndorf RA, et al. Pleiotropic effects of telmisartan: Still more to come? J Hypertension. 2008; 26(5):854–6. https:// doi.org/10.1097/HJH.0b013e3282f76481 PMid:18398324
Stafylas PC, Sarafidis PA. Carvedilol in hypertension treatment. Vasc Health Risk Manag. 2008 Feb; 4(1):23–30. https://doi.org/10.2147/vhrm.2008.04.01.23 PMid:18629377 PMCid:PMC2464772
Chobanian AV, Bakris GL, Black HR, Cushman WC, Green LA, Izzo JL, et al. Seventh Report of the joint national committee on prevention, detection, evaluation, and treatment of high blood pressure: The JNC report. JAMA. 2003; 289(19):2560–72. https://doi.org/10.1001/ jama.289.19.2560 PMid:12748199
Gupta R. Trends in hypertension epidemiology in India. J Hum Hypertens. 2004 Feb; 18(2):73–8. https://doi.org/10.1038/sj.jhh.1001633 PMid:14730320
Chrysant SG, Chyrysant GS, Dimas B. Current and future status of beta- blockers in the treatment of hypertension. Clinical Cardiology. 2008 Jun; 31(6):249–52. https://doi.org/10.1002/clc.20249 PMid:18543303
Saseen JJ, MacLaughlin. Hypetension. DiPiro JT, Talbert RL, Yee GC, Matzke GR, Wells BG, Posey LM, editors. Pharmacotherapy: A pathophysiologic approach. 9th ed. New York: McGraw-Hill Medical; 2014.
CDC: High blood pressure. Centers for Disease Control and Prevention; 2015. Available from: http://www.cdc.gov/ bloodpressure/index.htm
James PA, Oparil S, Carter BL, Cushman WC, DennisonHimmelfarb C, Handler K, Lackland DT, LeFevre M, MacKenzie TD, Ogedegbe O, Smith SC, Svetkey LP, Taler SJ, Townsend RR, Wright J, Narva AS, Ortiz E. Evidence based guideline for the management of high blood pressure in adults: report from the panel members appointed to the Eighth Joint National Committee (JNC 8). JAMA. 2014; 311(5):507–20. Available from: http://jama.jamanetwork.com/article.aspx?articleid=1791497 https://doi.org/10.1001/jama.2013.284427 PMid:24352797
Friedrich MG, Dahlof B, Sechtem U, Unger T, Knecht M. Telmisartan Effectiveness on Left Ventricular Mass Reduction (TELMAR) as assessed by mabnetic resonance imaging in patients with mild-to-moderate
hypertension- a prospective, randomized, double- blind comparison of telmisartan with metoprolol over a period of six months- rationale and study design. Journal of the Renin-Angiotensin-Aldosterone System. 2003 Dec; 4(4):234–43. https://doi.org/10.3317/jraas.2003.038 PMid:14689371
Ong HT, FRCP, Rozina G, FRCP. Selecting antihypertensive medication in patients with essential hypertension in Malaysia. Med J Malaysia. 2009; 64(1):2009 Mar.
Tomiyama H, Yamashina A. Beta- blockers in the management of hypertension and/or chronic kidney disease. International Journal of Hypertension. 2014; 1–7. https://doi.org/10.1155/2014/919256 PMid:24672712 PMCid:PMC3941231
Matchar DB, McCrory DC, Orlando LA, Patel MR, Patel UD, Patwardhan MB, et al. Systematic review: Comparative effectiveness of angiotensin- converting enzyme inhibitors and angiotensin II receptor blockers for treating essential hypertension. Ann Intern Med. 2008; 148:16–29. https:// doi.org/10.7326/0003-4819-148-1-200801010-00189 PMid:17984484
Agarwal A, Chhabra MK, Walia R, Gupta PD. Comparative evaluation of Metoprolol and Telmisartan in hypertensive patients. 2014 Jul; 3(2): 403–10. Available from: www.Ijmds.org
Kumar P, Kapoor AK, Singh HK, Kulshrestha M, Randomized. Interventional, prospective, comparative study to evaluate the antihypertensive efficacy and tolerability of Ramipril versus Telmisartan in stage 1 hypertensive patients with diabetes mellitus. Internet Journal of Medical Update. 2015 Jan; 10(1):15–25. https://doi.org/10.4314/ijmu.v10i1.4
Zou Z, Xi G–L, Yuan HB, Zhu Q-F, Shi X-Y. Telmisartan versus Angiotensin converting enzyme inhibitors in the treatment of hypertension: a meta-analysis of randomized controlled trials. Journals of Human Hypertension. 2008; 23(5):1-11.
Soni RK, Porter AC, Lash JP, Unruh ML. Health-related quality of life in hypertension, chronic kidney disease and coexistent chronic health conditions. Adv Chronic Kidney Dis. 2010 Jul; 17(4):e17–26. https://doi.org/10.1053/j.ackd.2010.04.002 PMid:20610351 PMCid:PMC2901238
Shanableh S, Abdulkarem A, Shamssain M, Sarhan F. Quality of life of hypertensive patients on different types of antihypertensive medications. IOSR Journal of Pharmacy. 2014 May; 4(5):23–8. https://doi.org/10.9790/30130405023028
- There are currently no refbacks.
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.