Abstract

CHOICE OF ANTIHYPERTENSIVE AND ITS EFFECTS ON DIABETIC-HYPERTENSIVE POPULATION

Anjalin Nicy Rockin*, Tina Das, Jefry Thomas, Koneru Sindhuja, Basavaraj K. Nanjwade

ABSTRACT

The microvascular and macrovascular events are quite common in the diabetic hypertensive patients. Tight blood pressure control and appropriate anti-hypertensive medication does prevent or delay such complications. Data was collected prospectively for a period of six months, from October 2014 to March 2015. Patients with a blood pressure above ≥140/90 mmHg were eligible for the study. Statistical analysis was performed according with the use of SPSS software. A survival curve was estimated according to the Kaplan–Meier procedure, and different variables were analyzed by multivariate coxregression analysis to find the association with the occurrence of an event and the treatment given. 199 patients were enrolled in the study. The mean age of the study population were found to be 62.95±12.33 years. Gender wise distribution showed that the majority of them were males, 59.8 %. The mean duration of diagnosis of Diabetes was 5.66 ±4.5 years and for hypertension were 3.81±3.33 years. There were 104 patients (52%) with Stage I hypertension and 95 patients (48 %) with Stage II hypertension. Telmisartan (28.1%) was the most frequently prescribed medication, followed by Amlodipine (17.1%). ARB’s (34.8%) was the frequently prescribed class of drug. Occurrences of microvascular and macrovascular events were reported in 82 (41.2 %) patients. In Kaplan Meier analysis age, duration of diagnosis of hypertension and diabetes as well as treatment given before admission to the hospital showed significance to the end points. On multivariate analysis, patients treated with Angiotensin receptor blockers on monotherapy showed significant lesser hazards of death. Females had higher blood pressure when compared to males. Angiotensin II receptor blockers were the preferred choice of class of drug for the management of hypertension as well as in reducing the occurrence of complications. Telmisartan was the most preferred option in ARB’s. Treatment with monotherapy was associated with reduced risk of occurrence of microvascular and macrovascular events.

Keywords: Diabetes, hypertension, telmisartan, ARB’s, anti-hypertensives.