Why the study?
Does telmisartan improve blood pressure reduction compared to metoprolol in patients with Grade I hypertension?
Does telmisartan improve blood pressure reduction compared to metoprolol in patients with Grade I hypertension?
In patients with Grade I hypertension, telmisartan 40 mg daily achieved greater reductions in systolic and diastolic blood pressure compared to metoprolol 50 mg daily over 12 weeks.
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Telmisartan may be preferred over metoprolol for BP control in Grade I hypertension; extends RCT evidence favoring ARBs versus beta-blockers.
Background : Epidemiological studies and clinical trials have shown that meticulous control of blood pressure is required in patients with hypertension to ensure decreased cardiovascular morbidity and mortality. Objective : To compare the effect of Metoprolol and Telmisartan on blood pressure reduction and heart rate in patients of Stage I Hypertension. Material and Methods : This was a prospective, randomized, open, parallel study conducted at the outpatient department of Medicine. Patients of either sex with Grade I Hypertension according to JNC VII, aged between 18-60 years were enrolled and followed up every 2 weeks from baseline till 12 weeks. Patients were randomly divided into two groups to receive tablet Metoprolol 50 mg (Group A, n=30) and Telmisartan 40 mg (Group B, n=30) once a day. Response to study treatments was evaluated in terms of decrease in Blood pressure and heart rate. Results were analysed using Student's 't' test. Results : Baseline characters of both the groups were well balanced. Systolic Blood Pressure was reduced by 7.5 % from Metoprolol and 12.9% by Telmisartan and Diastolic Blood Pressure was reduced by 8.2% in group A and 13.6% in group B. Both the drugs leads to significant reductions (i.e. P<0.05) in systolic as wel as diastolic BP. Heart rate reduction was significant and was observed to be more with the Metoprolol group i.e. 15.2% reduction as compared to 9.1% reduction with Telmisartan. Conclusion: Telmisartan is a better choice than Metoprolol in Indian Population for treating Grade I hypertension as it leads to greater reduction in Blood Pressure and less effect on Heart rate.
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Agarwal et al. (2014) studied this question.
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