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ORIGINAL ARTICLE
Year : 2017  |  Volume : 9  |  Issue : 1  |  Page : 56-65

Efficacy and tolerability of antihypertensive drugs in diabetic and nondiabetic patients


1 Cardiovascular and Medical Departments of Mayo Hospital Lahore, Surgical and Medical Units, Mayo Hospital, Lahore, Pakistan
2 Department of Pharmacy, Gulab Devi Hospital; Department of Pharmacy, University College of Pharmacy, University of the Punjab, Lahore, Pakistan
3 Department of Pharmacy, Medical Units, Mayo Hospital, Lahore, Pakistan

Correspondence Address:
Maria Aslam
Surgical and Medical Units, Mayo Hospital, Lahore
Pakistan
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jpbs.JPBS_308_16

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Objectives of the Study: The aim of the study was to compare the efficacy and tolerability of different classes of antihypertensive drugs in diabetic and nondiabetic patients(NDPs) with essential hypertension. Material and Methods: The study was conducted inMayo Hospital, Punjab Institute of Cardiology, and National Defence Hospital, Lahore, Pakistan,on 200 hypertensive patients with diabetes and 230 hypertensive patients without (Three hospitals) diabetes. Both male and female patients of age between 30 and 80years with systolic blood pressure(SBP) above 130mmHg and diastolic blood pressure(DBP) above 80mmHg were enrolled in the study. Angiotensin converting enzyme inhibitors(ACEI), beta-blocker(βB), calcium-channel blocker(CCB), diuretics(D), angiotensin receptor blocker(ARB) as well as α-blocker classes of antihypertensive drugs were used. These drugs were used as monotherapy as well as combination therapy. The study was conducted for 4months(July–October). After 4months, patients were assessed for efficacy by monitoring blood pressure(BP) and tolerability by assessing safety profile on renal function, liver function as well as lipid profile. Results: Significant control in mean BP by all drug groups was observed in “both groups that is patients with diabetes and without diabetes.” The efficacy and tolerability data revealed that in diabetic patients with hypertension, the highest decrease in SBP and DBP was observed using monotherapy with ACEI, two-drug combination therapy with ACEI plus diuretic, ARBs plus diuretic, ACEI plus CCBs, three-drug combination therapy with ACEI plus CCBs plus diuretic, and four drug combination therapy with ACEI plus CCBs plus diuretic plus βBs, ARB's plus CCBs plus diuretic plus βBs while in NDPs, monotherapy with diuretic, two-drug combination therapy with ACEI plus CCBs, ACEI plus βBs, three-drug combination therapy with βBs plus ACEI plus D was found more effective in controlling SBP as well as DBP. Adverse effects observed were dry cough, pedal edema, dizziness, muscular cramps, constipation, palpitations, sweating, vertigo, tinnitus, paresthesia, and sexual dysfunction. Conclusion: All classes of antihypertensives were found to control blood pressure significantly in both groups of patients that is diabetic patients with hypertesion and non-diabetic patients with hypertension.


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