Comparative Efficacy and Safety of Triple Therapy (Ramipril, Telmisartan, Hydrochlorothiazide) Vs Dual Anti Hypertensive Therapy (Ramipril or Telmisartan, Hydrochlorothiazide) in Stage 2 Hypertensive Patients
Published: August 1, 2014 | DOI: https://doi.org/10.7860/JCDR/2014/.4720
Bharat Bhushan, Seema Gupta, Vijay Khajuria, Dinesh Kumar, Mohan Lal, Dharminder Kumar, Sanjeev Bhat, Aman Sharma
1. Resident, Department of Pharmacology, Government Medical College, Jammu, India.
2. Assistant Professor, Department of Pharmacology, Government Medical College, Jammu, India.
3. Associate Professor, Department of Pharmacology, Government Medical College, Jammu, India.
4. Associate Professor, Department of Preventive and Social Medicine, Government Medical College, Jammu, India.
5. Professor, Department of Cardiology, Government Medical College, Jammu, India.
6. Assistant professor, Department of Cardiology, Government Medical College, Jammu, India.
7. Lecturer, Department of Cardiology, Government Medical College, Jammu, India.
8. Resident, Department of Pharmacology, Government Medical College, Jammu, India.
Correspondence Address :
Dr. Bharat Bhushan,
H.No. F-65, Upper Krishna Nagar, Near Resham Ghar Colony, Jammu 180016, India.
Phone : 9086065555, 9858911910, E-mail : bharat4rl@yahoo.com
Abstract
Aim: To evaluate the comparative efficacy and safety of ramipril 5mg plus hydrochlorothiazide 12.5mg (R + HCTZ), telmisartan 40mg plus hydrochlorothiazide12.5mg (T + HCTZ) and ramipril 2.5mg plus telmisartan 20mg plus hydrochlorothiazide12.5mg (R + T + HCTZ) in patients with stage 2 hypertension.
Material and Methods: A prospective, open label, randomized comparative study was conducted to study the comparative efficacy and safety of R+HCTZ (group 1), T+HCTZ ( group 2) and R+T+TCTZ (group3) in eighty eight patients with stage 2 hypertension without co morbid conditions. Echocardiography was done to assess left ventricular function. Patients were followed up to 24 weeks and any ADR occurring in this period was recorded.
Results: All the three treatment groups showed significant fall in both systolic and diastolic blood pressure compared to the baseline scores (p<0.0001).Intergroup comparison did not reveal any significant difference .Total number of adverse drug events reported were fifteen . Group III had higher percentage ADRs . Dry cough (8) was most common ADR . The echocardiography parameters did not change from baseline values with all three treatment regimens .
Conclusion: All three medications were of equal efficacy in patients with stage 2 hypertension without co morbid conditions, failing to prove superiority over each other.
Keywords
Hydrochlorothiazide, Ramipril, Stage 2 hypertension, Telmisartan, Triple therapy