The comparative study of the effect of telmisartan and ramipril on diabetic profile in hypertensive pre-diabetic patients
DOI:
https://doi.org/10.18203/2319-2003.ijbcp20203147Keywords:
Telmisartan, Ramipril, Hypertension, Pre-diabetes, Fasting blood sugar, Glycosylated haemoglobinAbstract
Background: Hypertension, a common cardiovascular disease, is being increasingly associated with other co-morbid conditions like Diabetes mellitus, worsening its outcome. Both telmisartan and ramipril are effective anti hypertensive agents. The present study compares the efficacy of telmisartan and ramipril in controlling or preventing the progression of pre-diabetes to diabetes in stage 1 hypertensive patients.
Methods: A prospective, randomised, single centre, comparative observational study is conducted over a period of 12 months on stage 1 hypertensive patients with pre-diabetes. 60 patients are recruited and randomised into two treatment groups. They received the assigned drug for a period of 12 months and are followed up. At each visit, blood pressure was measured and diabetic profile was tested.
Results: This study showed that both telmisartan and ramipril controlled the blood pressure effectively. Telmisartan controlled the progression of fasting blood sugar and glycosylated haemoglobin better than ramipril in stage 1 hypertensive patients with pre diabetes.
Conclusions: Both telmisartan and ramipril were affecting in controlling the blood pressures. Telmisartan has a statistically significant effect in preventing the progression of prediabetes to diabetes mellitus in stage 1 hypertensive patients with pre diabetes when compared with ramipril.
References
Chobanian AV, bakris GL, Black HR, Cushman WC, Green LA, Izzo JL Jr et al. The seventh report of the joint national committee or prevention, detection, evaluation & treatment of high blood pressure: The JNC 7 report. JAMA. 2003;289:2560-72.
Ibrahim MM. Damasceno A. Hypertension in developing countries. Lancet. 2012;380:6.
Lawes CM, vender HS, Rodgers A. Global burden of blood pressure related disease, 2001 Lancet. 2008;371:513.
Epsterm M, Sowers JR. Diabetes mellitus & hypertension. Hypertension 1992;19:403-18.
Sampanis C, Zamboules C. Arterial hypertension in diabetes mellitus: from theory to clinical practice. Hippokrata 2008;12:74-80.
ADA Guidelines prediabetes criteria. American diabetes association. Standards of medical care in diabetes - 2015. Diabetes Care. 2015;38(suppl. 1):S1-S93.
Prediabetes. J Indian Medical Association. 2005.
Brunton LL. Goodman & Gilmans: The pharmacological basis of therapeutics; 11th edition: section. Mc-Graw-Hill; 2006: 846.
Brunton LL. Goodman & Gilmans: The pharmacological basis of therapeutics; 11th edition: section V/chapter 32/ Page 846.
Goodman & Gilmans: The pharmacological basis of therapeutics; 11th edition: section V/chapter 32/ Page 846.
Ambade VN, Sharma YV, Somani BL. Methods of Estimation of Blood Glucose: A comparative evaluation. Med J Armed Forces India. 1998;54(2):131-2.
Gupta S, Jain U, Chauhan N. Laboratory Diagnosis of HbA1C: A Review. J Nanomed Res. 2017;5(4).
Isomaa B, Almgren P, Tuomi T. Cardiovascular morbidity & mortality associated with the metabolic syndrome. American Diabetes Association. Diabetes Care. 2001;24(4): 683-9.
Unger T, Targeting cardiovascular protection: the concept of dual renin - angiotensin system control. Medscape J Med. 2008;10 (Suppl):S4.
Kaschina E, Grzesiak A, Li J, Foryst-Ludwig A, Timm M, Rompe F, et al. Angiotensin II type 2 receptor stimulation: a novel option of therapeutic interference with the renin-angiotensin system in myocardial infarction? Circulation. 2008;118(24): 2523-32.
Derosa G, Ragonesi PD, Mugellini A, Ciccarelli L, Fogari R. Effects of telmisartan compared with eprosartan on blood pressure control, glucose metabolism and lipid profile in hypertensive, type2 diabetic patients: a randomized, double-blind, placebo-controlled 12-month study. Hypertens Res. 2004;27(7):457-64.
Benson SC, Pershadsingh HA, Ho CI. Identification of telmisartan as a unique angiotensin II receptor antagonist with selective PPAR gamma modulating activity. Hypertension. 2004;43:993-1002.
Battershill AJ, Scott LJ. Telmisartan. A review of its use in the management of hypertension. Drugs. 2006;66(1):51-83.
Clasen R, Schupp M, Foryst-Ludwig A, Sprang C, Clemenz M, Krikov M, et al. PPAR gamma-activating angiotensin type-1 receptor blockers induce adiponectin. Hypertension. 2005;46(1):137-43.
Berg AH, Scherer PE. Adipose tissue, inflammation, and cardiovascular disease. Circulation Res. 2005;96:939-49.
Han SH, Quon MJ, Kim JA, Koh KK. Adiponectin and cardiovascular disease: response to therapeutic interventions. J Am Coll Cardiol. 2007;49:531-8.
Scheen AJ. DREAM Study: Prevention of type 2 Diabetes with Ramipril and / or Rosiglitazone in persons with Dysglycaemia but no cardiovascular disease. Reviewed Med Liege. 2006;61(10):728-32.
