Randomized, interventional, prospective, comparative study to evaluate the antihypertensive efficacy and tolerability of ramipril versus telmisartan in stage 1 hypertensive patients with diabetes mellitus

Abstract

Angiotensin converting enzyme inhibitors and angiotensin receptor blockers are keystones for therapy of hypertension in diabetes because they show favourable effects on diabetic nephropathy and cardiovascular disease outcomes. A prospective, randomized, interventional clinical study of one year duration was conducted to comparatively evaluate anti-hypertensive efficacy and tolerability profile of ramipril versus telmisartan in stage 1 hypertensive patients associated with type 2 diabetes mellitus, amongst patients of either sex attending the medicine OPD of Rohilkhand Medical College and Hospital, Bareilly. Clearance from institutional ethical committee and written informed consent of the participants was taken. The enrolled 222 patients were randomized into ramipril and telmisartan groups, of these only 192 patients completed the study. The data obtained were statistically analyzed by paired and unpaired t-test using SPSS software. Prevalence of hypertension in diabetics was more in 41 to 50 years age group, in females (male: female ratio= 0.92:1) and in rural areas (rural: urban ratio= 0.61:1). Baseline BP values were equally matched in both groups. The SBP and DBP were reduced from baseline in all the ten follow-ups and were statistically significant (p <0.0001 for both groups). Regarding adverse effects, both drugs were well tolerated though dry irritating cough and dizziness was more in ramipril group. Both ramipril and telmisartan as monotherapy were equally effective in lowering SBP and DBP on prolonged use in diabetic hypertensives but the incidence of adverse effects was higher with ramipril hence telmisartan be preferred.

KEY WORDS: Ramipril; Telmisartan; Systolic; Diastolic blood pressure; Stage 1
hypertensive patients; Diabetes mellitus