Kumar Manish, Mohan Lalit, Dikshit Harihar
Senior Resident, Department of Pharmacology, IGIMS , Sheikhpura, Patna-14, Bihar, India .
Associate Professor, Department of Pharmacology, IGIMS , Sheikhpura, Patna-14, Bihar, India .
J Clin Diagn Res. 2014 Apr;8(4):HC07-9. doi: 10.7860/JCDR/2014/8012.4275. Epub 2014 Apr 15.
Angiotensin Converting Enzyme Inhibitors (ACEI) and Angiotensin Receptor Blockers (ARBs) has been a major therapeutic advance in the management of hypertensive patients. This study was designed to compare adverse effects on renal markers in treatment with two commonly used drugs Perindopril and Telmisartan in cases of Hypertension. This was an 'observational' and 'cross-sectional' study.
This study was conducted in two groups, Group A (Newly diagnosed hypertensive patients) and Group B (Old but poorly controlled hypertensive), each had 100 patients. In both groups, half the patients were given Perindopril 4 mg OD and half were given Telmisartan 40 mg OD for 24 weeks. If blood pressure was not controlled, dose was titrated to response and increased to 8 mg OD and 80 mg OD for Perindopril and Telmisartan respectively to keep mean arterial pressure between 90-115 mmHg. The adjusted dose was kept constant in both groups. Blood urea, serum creatinine and creatinine clearance was estimated initially and then at 4(th), 12(th) and 24(th) week.
Treatment with Perindopril showed that mean baseline values for blood urea, serum creatinine and creatinine clearance in newly diagnosed and old hypertensive patients were 30.88, 1.37, 64.09 and 33.68, 1.53, 55.98, respectively. After study period these values were 32.24, 1.40, 63.97 and 29.80, 1.46, 59.23 respectively (p value > 0.05). Treatment with telmisartan showed that mean baseline values of blood urea, serum creatinine and creatinine clearance in both group of patients were 30.88, 1.52, 59.31, and 31.72, 1.40, 65.67, respectively. After treatment these values in both groups were 31.92, 1.43, 62.66; and 32.20, 1.46, 61.70, respectively (p value > 0.05).
It concluded that both Perindopril and Telmisartan significantly reduces systolic, diastolic and mean arterial pressure without any significant effect on renal function in both newly diagnosed and old hypertensive patients.
血管紧张素转换酶抑制剂（ACEI）和血管紧张素受体阻滞剂（ARB）是高血压患者治疗方面的一项重大进展。本研究旨在比较常用药物培哚普利和替米沙坦治疗高血压时对肾脏指标的不良反应。这是一项“观察性”和“横断面”研究。
本研究分为两组，A组（新诊断的高血压患者）和B组（老年但血压控制不佳的高血压患者），每组各有100名患者。两组中，一半患者给予培哚普利4毫克每日一次，另一半给予替米沙坦40毫克每日一次，治疗24周。如果血压未得到控制，则根据反应调整剂量，培哚普利和替米沙坦分别增至8毫克每日一次和80毫克每日一次，以使平均动脉压维持在90 - 115毫米汞柱之间。两组的调整剂量均保持不变。最初以及在第4、12和24周时分别估算血尿素、血清肌酐和肌酐清除率。
培哚普利治疗显示，新诊断和老年高血压患者血尿素、血清肌酐和肌酐清除率的平均基线值分别为30.88、1.37、64.09和33.68、1.53、55.98。研究期结束后，这些值分别为32.24、1.40、63.97和29.80、1.46、59.23（p值>0.05）。替米沙坦治疗显示，两组患者血尿素、血清肌酐和肌酐清除率的平均基线值分别为30.88、1.52、59.31和31.72、1.40、65.67。治疗后，两组的这些值分别为31.92、1.43、62.66和32.20、1.46、61.70（p值>0.05）。
得出结论，培哚普利和替米沙坦均可显著降低新诊断和老年高血压患者的收缩压、舒张压和平均动脉压，且对肾功能无任何显著影响。
