DOI: http://dx.doi.org/10.18203/2319-2003.ijbcp20160762

Comparative study of amlodipine versus ramipril and their effects on markers of renal disease in type 2 diabetes mellitus

Raj Kumar, KMDS Panag, Kavita Paul, Kamlesh Kohli, H. L. Kazal

Abstract


Background: Diabetes mellitus is a chronic metabolic condition and patients require long treatment for it. The aim of the study was to evaluate the effects of amlodipine and ramipril on the blood pressure and markers of renal disease (viz. serum creatinine, albuminuria and eGFR) in type 2 diabetes mellitus.

Methods: This was a randomized, open labelled, parallel study conducted to assess the effect of Amlodipine (2.5-10 mg) and Ramipril (2.5-10 mg) daily for 24 weeks in T2DM patients (n=103). Patients were recruited from department of Medicine OPD/Ward in the GGS Hospital and Medical College, Faridkot. Subjects in the age group of 30- 80 years who had T2DM with or without hypertension were enrolled and randomly divided into two groups viz. Group A (n=51, amlodipine 2.5 to 10 mg/day) and Group B (n=52, ramipril 2.5 to 10mg/day). Patients were evaluated at day 0 and then at 12 and 24 weeks for Blood pressure, S. Creatinine, albuminuria, eGFR and other routine investigations.

Results: At 24 weeks SBP, DBP and MAP values were decreased significantly in both the groups (p <0.0001, each). At 24 weeks, there were increased in the levels of albumin in urine (59.87%, p<0.0001) and serum creatinine (24.93%, p< 0.001) in the Amlodipine group while fall in these levels were observed (26.75%, p<0.0001 and 5.95%, p>0.05) in Ramipril group. eGFR was decreased (9.73%, p <0.01) in Amlodipine group while increased in Ramipril group (10.29%, p<0.01 %).

Conclusions: Both amlodipine and ramipril are equally efficacious in improving SBP, DBP and MAP in T2DM patients. Whereas, ramipril is also improves the markers/predictors of renal disease (viz. serum creatinine, albumin level in urine and eGFR) in T2DM patients, furthermore, it is having renoprotective action in an addition to lowering raised blood pressure which is useful to treat diabetic nephropathy cases.


Keywords


T2DM, Predicators/Markers of renal disease, ACEI (Angiotensin Converting Enzyme Inhibitor), Blood Pressure, Calcium channel blocker (CCBs), Renoprotective, eGFR, Microalbuminuria

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