Efficacy and Tolerability of Different Antihypertensive Drugs in Diabetic Patients with Mild to Moderate Hypertension in a Multi Speciality Hospital - A Prospective Comparative Study

Aim: To compare the efficacy and tolerability of different antihypertensive drugs in diabetic patients with hypertension. Materials and methods: A prospective, comparative study was conducted in 370 diabetes patients suffering from mild to moderate hypertension of either sex aged between 30-80 years. Patients with systolic blood pressure (SBP) above 130 mm Hg and patients with diastolic blood pressure (DBP) above 80 mm Hg were included in the study. Drugs used were ACE Inhibitor (ACE I), Beta blocker (BB), Calcium channel blocker (CCB) and Diuretic in monotherapy (n=134) and in 2 and 3 drugs combination (n=236). After 8 weeks of therapy patients were assessed for efficacy and tolerability. Results: Males were 51.3% and females 48.6%. There was a significant control (P<0.01) in mean blood pressure in 90% of patients. Highest decrease in SBP was seen with ACE I+BB+Diuretic combination (39%) and in DBP with CCB+Diuretic combination (18.8%). A total of 74.5% of patients were prescribed ACE I in monotherapy and combination therapy groups. Adverse drug reactions (ADRs) reported were pedal edema, dry cough, headache, dizziness and muscle cramps. Discussion and conclusion: All the drug groups from monotherapy and combination therapy reduced BP effectively. Most effective groups were ACE I+BB+Diuretic and CCB+Diuretic combination. ACE I was effective and most frequently used drug. Two drug combination therapies were commonly prescribed – 50.2%.