Gadge Pradeep, Gadge Roshani, Paralkar Nikita, Jain Preeti, Tanna Vrunda
Department of Diabetology, Dr. Gadge's Diabetes Care and Research Centre, Mumbai, Maharashtra, India.
Perspect Clin Res. 2018 Oct-Dec;9(4):155-160. doi: 10.4103/picr.PICR_93_17.
Telmisartan is one of the preferred choices of antihypertensive in patients of diabetes with hypertension (HTN) and lowers blood pressure (BP) effectively.
The objective of the study was to determine BP-lowering efficacy of telmisartan monotherapy in patients of Stage I HTN with or without complications of type 2 diabetes mellitus (T2DM).
In this retrospective study, patients of T2DM without (Group A) or with (Group B) complications who had Stage I HTN and were prescribed telmisartan (20-80 mg/day) treatment were identified from database. Patients included were adults 18 years and above with BP ≥140/80 mmHg but <160/100 mmHg. Data related to demographics, systolic and diastolic BP, blood glucose parameters, and weight before initiation of telmisartan and at the end of 12 weeks treatment were compared with appropriate statistics.
In 132 patients included, 28 (21.2%) patients had one or more complications of T2DM. Mean age in Group A and B was similar whereas mean duration of diabetes was significantly higher in Group B than Group A (10.0 ± 5.8 vs. 7.1 ± 5.9, = 0.023). Telmisartan 40 mg was most frequently used strength (97.1% and 100.0% patients in two groups). Change from baseline in systolic BP in Groups A and B was -19.5 mmHg (95% confidence interval [CI] -16.3, -22.7; < 0.0001) and -24.9 mmHg (95% CI -17.3, -32.5; < 0.0001), respectively. Reduction in diastolic BP was also significant in two groups. There were no significant differences in adjusted means of systolic and diastolic BP in two groups. In Group A and B, change from baseline in fasting glucose was -3.7 mg/dL ( = 0.647) and -8.4 mg/dL ( = 0.593); in postmeal glucose was -14.8 mg/dL ( = 0.280) and -36.9 mg/dL ( = 0.046), respectively.
Telmisartan is effective in lowering BP and improving metabolic parameters in patients of T2DM with or without complications. A larger and long duration study is needed to substantiate our findings.
替米沙坦是糖尿病合并高血压患者抗高血压的首选药物之一，能有效降低血压（BP）。
本研究的目的是确定替米沙坦单药治疗对伴有或不伴有2型糖尿病（T2DM）并发症的I期高血压患者的降压疗效。
在这项回顾性研究中，从数据库中识别出患有I期高血压且接受替米沙坦（20 - 80mg/天）治疗的无并发症（A组）或有并发症（B组）的T2DM患者。纳入的患者为18岁及以上的成年人，血压≥140/80mmHg但<160/100mmHg。将替米沙坦治疗开始前及治疗12周结束时的人口统计学数据、收缩压和舒张压、血糖参数及体重数据进行适当的统计学比较。
纳入的132例患者中，28例（21.2%）患有一种或多种T2DM并发症。A组和B组的平均年龄相似，而B组的糖尿病平均病程显著高于A组（10.0±5.8 vs. 7.1±5.9，P = 0.023）。替米沙坦40mg是最常用的剂量（两组分别为97.1%和100.0%的患者）。A组和B组收缩压较基线的变化分别为-19.5mmHg（95%置信区间[CI] -16.3，-22.7；P < 0.0001）和-24.9mmHg（95%CI -17.3，-32.5；P < 0.0001）。两组舒张压的降低也很显著。两组收缩压和舒张压的调整均值无显著差异。在A组和B组中，空腹血糖较基线的变化分别为-3.7mg/dL（P = 0.647）和-8.4mg/dL（P = 0.593）；餐后血糖的变化分别为-14.8mg/dL（P = 0.280）和-36.9mg/dL（P = 0.046）。
替米沙坦对伴有或不伴有并发症的T2DM患者有效降低血压并改善代谢参数。需要进行更大规模和更长时间的研究来证实我们的发现。
