Comparative study of telmisartan and amlodipine to assess the effect on blood pressure, lipid profile and blood glucose level in Indian hypertensive patients

  • Dr Neeraj Tripathi Assistant Professor, Department of Medicine ex-junior resident BRD Medical College, Gorakhpur, UP, India
  • Dr Sangita Bohara Assistant Professor, Department of Pathology, Hind Institute of Medical Sciences, Safedabad, Barabanki, U.P, India
  • Dr R. R. Singh Associate Professor, Department of Medicine, Hind Institute of Medical Sciences, Safedabad, Barabanki, U.P, India
  • Dr Anoop Kumar Assistant Professor, Department of Medicine, Hind Institute of Medical Sciences, Safedabad, Barabanki, U.P, India
  • Dr Pooja Dhoan Assistant Professor, Department of Medicine, Hind Institute of Medical Sciences, Safedabad, Barabanki, U.P, India
  • Dr D.Uraiya Hind Institute of Medical Sciences, Safedabad, Barabanki, U.P, India
Keywords: Telmisartan, Amlodipine, Metabolic syndrome, Hypertension, Blood pressure

Abstract

Introduction: Hypertension is emerging as a major health problem and while treating a patient with hypertension it is not only necessary to control blood pressure but also treat the associated risk factors which lead to metabolic syndrome.

Methods: A randomized comparative study was designed to evaluate the effect of telmisartan on blood pressure (BP), lipid profile and blood glucose levels in hypertensive patients. This was compared with amlodipine with 1:1 randomisation. BP>140mm Hg (systolic) and >90mm Hg (diastolic) as well as body mass index (BMI) was taken in consideration. Blood sugar levels, lipid profile and urine samples were collected for protein and sugar. These samples were collected at baseline (first visit) and after 6 months.

Results: The mean value of systolic BP in telmisartan group decreased from baseline by 17.43% (p<0.001) and 13.79% in diastolic BP (p<0.001). On comparing with amlodipine, telmisartan reduced mean systolic BP significantly more by 8.42% (p<0.001) and 5.59% (p<0.001) in diastolic BP. The mean fasting sugar level in patients with telmisartan group after 6 months was 100.70mg% which decreased by 10.27% (p<0.01) from baseline The effect of post prandial sugar level in telmisartan group was a reduction of 5.57mg% from baseline (p<0.001). There was significant reduction in mean value of urinary protein from 160.22mg% to 92.22 mg% (p<0.001).

Conclusion: Besides significant reduction in BP, telmisartan also had beneficial effects on various metabolic parameters, where amlodipine was not effective. The salutary effects of telmisartan on the metabolic profile may be additional attribute beyond its established antihypertensive effect.

Downloads

Download data is not yet available.

References

Anand MP. Epidemiology of hypertension India. Indian Heart J. 2010 Sep-Oct;62(5):388-93.

Kaur J. A comprehensive review on metabolic syndrome. Cardiol Res Pract. 2014;2014:943162. doi: https://doi.org/10.1155/2014/943162. Epub 2014 Mar 11.

Chobanian AV, Bakris GL, Black HR, Cushman WC, Green LA, Izzo Jr JL, Jones DW, Materson BJ, Oparil S, Wright Jr JT, Roccella EJ. The seventh report of the joint national committee on prevention, detection, evaluation, and treatment of high blood pressure: the JNC 7 report. Jama. 2003 May 21;289(19):2560-71.doi: https://doi.org/10.1001/jama.289.19.2560.

Inoue T, Morooka T, Moroe K, Ikeda H, Node K. Effect of telmisartan on cholesterol levels in patients with hypertension - Saga Telmisartan Aggressive Research (STAR). Horm Metab Res. 2007 May;39(5):372-6.doi: https://doi.org/10.1055/s-2007-976544.

Benson SC, Pershadsingh HA, Ho CI, Chittiboyina A, Desai P, Pravenec M, Qi N, Wang J, Avery MA, Kurtz TW. Identification of telmisartan as a unique angiotensin II receptor antagonist with selective PPARγ–modulating activity. Hypertension. 2004 May 1;43(5):993-1002.doi: https://doi.org/10.1161/01.hyp.0000123072.34629.57.

Schupp M, Janke J, Clasen R, Unger T, Kintscher U. Angiotensin type 1 receptor blockers induce peroxisome proliferator–activated receptor-γ activity. Circulation. 2004 May 4;109(17):2054.doi: https://doi.org/10.1161/01.cir.0000127955.36250.65.

Gress TW, Nieto FJ, Shahar E, Wofford MR, Brancati FL. Hypertension and antihypertensive therapy as risk factors for type 2 diabetes mellitus. Atherosclerosis Risk in Communities Study. N Engl J Med. 2000 Mar 30;342(13):905-12.doi: https://doi.org/10.1056/nejm200003303421301.

Isomaa BO, Almgren P, Tuomi T, Forsén B, Lahti K, Nissén M, Taskinen MR, Groop L. Cardiovascular morbidity and mortality associated with the metabolic syndrome. Diabetes care. 2001 Apr 1;24(4):683-9.doi: https://doi.org/10.2337/diacare.24.4.683.

Dahlof B, Sever PS, Ponter NR. Prevention of cardiovascular events with an antihypertensive regimen of amlodipine adding perindopril as required versus atenolol adding bendroflumethazide as required, in the Ansloscandinavian cardiac outcomes trial-blood pressure lowering arm (ASCOT-BPLA): a multicentre randomized controlled trial. Lancet 2005;366:895-906.

ALLHAT Officers and Coordinators for the ALLHAT Collaborative Research Group. The Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial. Major outcomes in high-risk hypertensive patients randomized to angiotensin-converting enzyme inhibitor or calcium channel blocker vs diuretic: The Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT). JAMA. 2002 Dec 18;288(23):2981-97.doi: https://doi.org/10.1001/jama.288.23.2981.

Vitale C, Mercuro G, Castiglioni C, Cornoldi A, Tulli A, Fini M, Volterrani M, Rosano GM. Metabolic effect of telmisartan and losartan in hypertensive patients with metabolic syndrome. Cardiovasc Diabetol. 2005 May 15;4:6.doi: https://doi.org/10.1186/1475-2840-4-6.

Lacourcière Y, Krzesinski JM, White WB, Davidai G, Schumacher H. Sustained antihypertensive activity of telmisartan compared with valsartan. Blood Press Monit. 2004 Aug;9(4):203-10.doi: https://doi.org/10.1097/00126097-200408000-00005.

Derosa G, Cicero AF, Bertone G, Piccinni MN, Fogari E, Ciccarelli L, Fogari R. Comparison of the effects of telmisartan and nifedipine gastrointestinal therapeutic system on blood pressure control, glucose metabolism, and the lipid profile in patients with type 2 diabetes mellitus and mild hypertension: a 12-month, randomized, double-blind study. Clin Ther. 2004 Aug;26(8):1228-36.doi: https://doi.org/10.1016/s0149-2918(04)80049-3.

Dormandy JA, Charbonnel B, Eckland DJ, Erdmann E, Massi-Benedetti M, Moules IK, Skene AM, Tan MH, Lefèbvre PJ, Murray GD, Standl E, Wilcox RG, Wilhelmsen L, Betteridge J, Birkeland K, Golay A, Heine RJ, Korányi L, Laakso M, Mokán M, Norkus A, Pirags V, Podar T, Scheen A, Scherbaum W, Schernthaner G, Schmitz O, Skrha J, Smith U, Taton J; PROactive Investigators. Secondary prevention of macrovascular events in patients with type 2 diabetes in the PROactive Study (PROspective pioglitAzone Clinical Trial In macroVascular Events): a randomised controlled trial. Lancet. 2005 Oct 8;366(9493):1279-89.doi: https://doi.org/10.1016/s0140-6736(05)67528-9.

Bakris G, Burgess E, Weir M, Davidai G, Koval S; AMADEO Study Investigators. Telmisartan is more effective than losartan in reducing proteinuria in patients with diabetic nephropathy. Kidney Int. 2008 Aug;74(3):364-9. doi: https://doi.org/10.1038/ki.2008.204. Epub 2008 May 21.

Lewis EJ, Hunsicker LG, Clarke WR, Berl T, Pohl MA, Lewis JB, Ritz E, Atkins RC, Rohde R, Raz I; Collaborative Study Group. Renoprotective effect of the angiotensin-receptor antagonist irbesartan in patients with nephropathy due to type 2 diabetes. N Engl J Med. 2001 Sep 20;345(12):851-60.doi: https://doi.org/10.1056/nejmoa011303.

Comparative study of telmisartan and amlodipine to assess the effect on blood pressure, lipid profile and blood glucose level in Indian hypertensive patients
CITATION
DOI: 10.17511/ijmrr.2016.i09.30
Published: 2016-09-30
How to Cite
1.
Tripathi N, Bohara S, Singh RR, Kumar A, Dhoan P, Uraiya D. Comparative study of telmisartan and amlodipine to assess the effect on blood pressure, lipid profile and blood glucose level in Indian hypertensive patients. Int J Med Res Rev [Internet]. 2016Sep.30 [cited 2024Apr.26];4(9):1693-701. Available from: https://ijmrr.medresearch.in/index.php/ijmrr/article/view/701
Section
Original Article

Most read articles by the same author(s)