A Comparative Evaluation of Ramipril as Monotherapy and Combination of Ramipril with Torsemide in Hypertension OC05-OC09
Dr. Ravinder Garg,
Professor and Head, Department of Medicine, GGS Medical College and Hospital, Faridkot-151203, Punjab, India.
Introduction: A Fixed-Dose Combination (FDC) of antihypertensive agents of different groups might offer advantages of efficacy, tolerability and compliance over monotherapy.
Aim: To compare efficacy and tolerability of ramipril/torsemide FDC with ramipril monotherapy.
Materials and Methods: This prospective open labeled randomized comparative study was conducted on newly diagnosed 100 patients, suffering from primary hypertension. They were divided in two groups viz., Group A (Ramipril 5 mg/day) and Group B (Ramipril 5 mg with Torsemide 5 mg/day). The study drugs were prescribed for a period of 12 weeks. To find comparative efficacy, the primary goal BP was set at less than 140 mmHg systolic and 90 mmHg diastolic blood pressure. Haematological and biochemical assessments were embedded in the methods at baseline and at the end of study. All the participants were evaluated for dyselectrolytemia, Blood urea, Serum Creatinine, and lipid profile during the study period at baseline and three follow ups at 4th, 8th and 12th weeks along with recording of adverse drug reactions. To assess tolerability of both regimens, the participants were interviewed followed by physical examination and laboratory investigation.
Results: The participants on FDC therapy (ramipril and torsemide) had shown significant reduction in ambulatory and office-measure BP compared to the participants on monotherapy (ramipril) with Stage I and Stage II hypertension. The goal BP was achieved with combination therapy in 4 weeks compared to monotherapy that was achieved in eight weeks. In the safety profiles, mild adverse drug reactions were reported with both the therapies.
Conclusion: FDC treatment showed significant fall in systolic BP after 4 weeks and diastolic BP after 12 weeks compared to the monotherapy while both the regimens were well tolerated.