Study of utilization pattern and analysis of efficacy of newer angiotensin receptor blockers in patients with hypertension and type-II diabetes with or without hypertension

Background: Interventions that target blood pressure control and proteinuria, specifically interruption of the Renin-angiotensin-aldosterone system (RAAS), have been utilized in attenuating cardiovascular complications. Angiotensin receptor blockers (ARBs) have been reported to have certain advantages. The objective of the study was to evaluate and compare the utilization pattern and efficacy of different ARBs in patients with HTN and associated type-II diabetes.Methods: Hypertensive patients with or without type-II diabetes treated with ARB based regimen were selected. The BP and 24 hours urinary albumin excretion were analysed at baseline and after three months of treatment.Results: Mean reduction in systolic blood pressure(SBP) was more with ARBs and calcium channel blocker(CCB) combination. Telmisartan alone and with ACEI reduced diastolic blood pressure (DBP) maximally in diabetic hypertensive patients. Proteinuria was significantly reduced with telmisartan (p<0.001) and olmesartan (p<0.05) based therapy. The side effects were minimal with ARB based therapy. Telmisartan was the costliest among all ARBsConclusions: There was suboptimal use of combination therapy in diabetic hypertensive patients. Telmisartan was having the better control on 24hr urinary albumin excretion.