Comparative Efficacy and Safety of Triple Therapy (Ramipril, Telmisartan, Hydrochlorothiazide) Vs Dual Anti Hypertensive Therapy (Ramipril or Telmisartan, Hydrochlorothiazide) in Stage 2 Hypertensive Patients

摘要

Aim: To evaluate the comparative efficacy and safety of ramipril5mg plus hydrochlorothiazide 12.5mg (R + HCTZ), telmisartan40mg plus hydrochlorothiazide12.5mg (T + HCTZ) and ramipril2.5mg plus telmisartan 20mg plus hydrochlorothiazide12.5mg(R + T + HCTZ) in patients with stage 2 hypertension.Materials and Methods: A prospective, open label, randomizedcomparative study was conducted to study the comparativeefficacy and safety of R+HCTZ (group 1), T+HCTZ ( group 2)andR+T+TCTZ (group3) in 88 patients with stage 2 hypertensionwithout co-morbid conditions. Echocardiography was done toassess left ventricular function. Patients were followed up to 24weeks and any ADR occurring in this period was recorded.Results: All the three treatment groups showed significant fallin both systolic and diastolic blood pressure compared to thebaseline scores (p<0.0001). Intergroup comparison did notreveal any significant difference. Total number of adverse drugevents reported were 15. Group III had higher percentage ADRs.Dry cough (8) was most common ADR. The echocardiographyparameters did not change from baseline values with all threetreatment regimens.Conclusion: All three medications were of equal efficacy inpatients with stage 2 hypertension without co morbid conditions,failing to prove superiority over each other.