Abstract

A Prospective Comparative Study of Efficacy and Pleiotropic Effect of Telmisartan versus Enalapril in Hypertensive Patients with Dyslipidaemia in a Tertiary Care Hospital in Visakhapatnam

Author(s): Supriya Sanke1, Chitra Karuppiah2, Hema Sundar Rao Dumpala3, Sai Vishnu Vardhan Allu4, Syamala Shanthi Kumari Bonela5

BACKGROUND
Hypertension is a silent killer, an asymptomatic chronic disorder if left untreated
which results in major health problems. Goal of treatment is to decrease the
morbidity and mortality associated with cardiovascular and cerebrovascular
complications of hypertension when it is associated with dyslipidaemia. The renin
angiotensin system plays an important role in the regulation of blood pressure and
in the pathogenesis of hypertension. Telmisartan is an ARB (angiotensin receptor
blocker) and Enalapril is an ACE inhibitor. The purpose of this study is to compare
the efficacy of Telmisartan with Enalapril in patients of essential hypertension with
dyslipidaemia, and to observe the effects of Telmisartan and Enalapril on blood
lipid levels of these patients.
METHODS
This is a prospective, randomized, comparative and open label study conducted
among 70 patients who were included in the study and were divided in to two
groups. Group A - consisting of 35 patients receiving Telmisartan 40 mg, and
Group B receiving Enalapril 5 mg orally once a day. Informed consent was obtained
from all the patients. Follow up was done after 4, 8 and 12 weeks. Blood pressure
was recorded at every visit and lipid profile was done at the time of enrolment and
after 12 weeks of study period.
RESULTS
Baseline demographic attributes were comparable between both the groups
including total cholesterol and low-density lipoprotein (LDL). The mean reduction
in systolic and diastolic blood pressure (BP) after 12 weeks was highly significant
(P value < 0.001) in both the groups but when mean reduction in SBP & DBP was
compared, there was no significant difference (P > 0.05) between the drugs. Blood
levels of total cholesterol, LDL, triglyceride had significantly reduced (P < 0.05) in
Telmisartan group compared to Enalapril group after 12 weeks of follow up and
mean high density lipoprotein (HDL) level significantly increased in Telmisartan
group (P < 0.05) but no increment was seen in Enalapril group.
CONCLUSIONS
Telmisartan and Enalapril had comparable antihypertensive effect and significant
reduction in blood pressure was seen after 12 weeks of therapy in both the groups.
In addition, Telmisartan showed more beneficial effects on lipid profile when
compared to Enalapril.