Bhardwaj Raj Kumar, Kazal H L, Kohli Kamlesh, Raj Rajnish, Bansal Nagma, Singh Baltej, Arora Hobinder
Department of Pharmacology, GGS Medical College and Hospital, Baba Farid University of Health Sciences, Faridkot, India.
Department of Medicine, PIMS, Jalandhar, India.
Perspect Clin Res. 2022 Jul-Sep;13(3):137-144. doi: 10.4103/picr.PICR_15_20. Epub 2021 Jan 8.
Diabetes mellitus is a chronic noncommunicable disease, and hypertension (HT) is the most common comorbidity which affects their quality of life (QoL).
The aim of the study was to assess the effects of antihypertensive agents (viz., amlodipine, ramipril, telmisartan, and ramipril with telmisartan) on the blood pressure (BP) and QoL.
It was an open-labeled prospective intention-to-treat study done in diabetic hypertensive patients (/2016/10). Patients were randomly assigned antihypertensive agents, namely, amlodipine, ramipril, telmisartan, and a combination of ramipril with telmisartan (RT) in four groups. They were evaluated for BP, blood sugar level, and QoL at baseline and 24 week.
After 24 weeks of therapy, systolic BP (SBP) and diastolic BP (DBP) were significantly reduced in all groups. In amlodipine, there was a mean percentage fall of SBP by 15.85% (confidence interval [CI]: 21.38-28.13) and DBP by 11.22% (CI: 8.41-12.70); in ramipril - 14.4% (CI: 18.61-25.15) and 12.4% (CI 8.88-13.99); telmisartan - 18.4% (CI: 24.89-10.79) and 14.6% (CI 10.79-16.24); and in RT group, SBP 17.7% (CI: 23.38-29.18) and DBP 12.4% (CI: 9.05-13.02). QoL score increased by 30.56% (CI: 14.30-10.90), 30.94% (CI: 14.21-10.68), 28.07% (CI: 14.89-11.20), and 28.84% (CI: 15.49-11.77), in respective groups ( < 0.0001, each). However, they were nonsignificant between the study groups ( > 0.05).
Amlodipine, ramipril, telmisartan, and a combination of RT are equally effective to improve BP and QoL among diabetic hypertensive patients. However, amlodipine and telmisartan lacked in dry cough and more tolerable than the ramipril and RT therapy. Henceforth, amlodipine and telmisartan are better choice to control HT among DM patients.
糖尿病是一种慢性非传染性疾病，高血压（HT）是影响其生活质量（QoL）的最常见合并症。
本研究旨在评估抗高血压药物（即氨氯地平、雷米普利、替米沙坦以及雷米普利与替米沙坦联用）对血压（BP）和生活质量的影响。
这是一项在糖尿病高血压患者中进行的开放标签前瞻性意向性治疗研究（/2016/10）。患者被随机分为四组，分别给予抗高血压药物，即氨氯地平、雷米普利、替米沙坦以及雷米普利与替米沙坦联用（RT）。在基线和24周时对他们的血压、血糖水平和生活质量进行评估。
治疗24周后，所有组的收缩压（SBP）和舒张压（DBP）均显著降低。在氨氯地平组，SBP平均下降百分比为15.85%（置信区间[CI]：21.38 - 28.13），DBP下降11.22%（CI：8.41 - 12.70）；雷米普利组 - SBP下降14.4%（CI：18.61 - 25.15），DBP下降12.4%（CI 8.88 - 13.99）；替米沙坦组 - SBP下降18.4%（CI：24.89 - 10.79），DBP下降14.6%（CI 10.79 - 16.24）；在RT组，SBP下降17.7%（CI：23.38 - 29.18），DBP下降12.4%（CI：9.05 - 13.02）。各治疗组的生活质量评分分别提高了30.56%（CI：14.30 - 10.90）、30.94%（CI：14.21 - 10.68）、28.07%（CI：14.89 - 11.20）和28.84%（CI：15.49 - 11.77）（每组P < 0.0001）。然而，各研究组之间差异无统计学意义（P > 0.05）。
氨氯地平、雷米普利、替米沙坦以及RT联用在改善糖尿病高血压患者的血压和生活质量方面同样有效。然而，氨氯地平和替米沙坦无干咳副作用，比雷米普利和RT治疗耐受性更好。因此，氨氯地平和替米沙坦是控制糖尿病患者高血压的更好选择。
