BACKGROUND Hypertension is a silent killer, an asymptomatic chronic disorder if left untreated which results in major health problems. Goal of treatment is to decrease the morbidity and mortality associated with cardiovascular and cerebrovascular complications of hypertension when it is associated with dyslipidaemia. The renin angiotensin system plays an important role in the regulation of blood pressure and in the pathogenesis of hypertension. Telmisartan is an ARB (angiotensin receptor blocker) and Enalapril is an ACE inhibitor. The purpose of this study is to compare the efficacy of Telmisartan with Enalapril in patients of essential hypertension with dyslipidaemia, and to observe the effects of Telmisartan and Enalapril on blood lipid levels of these patients. METHODS This is a prospective, randomized, comparative and open label study conducted among 70 patients who were included in the study and were divided in to two groups. Group A - consisting of 35 patients receiving Telmisartan 40 mg, and Group B receiving Enalapril 5 mg orally once a day. Informed consent was obtained from all the patients. Follow up was done after 4, 8 and 12 weeks. Blood pressure was recorded at every visit and lipid profile was done at the time of enrolment and after 12 weeks of study period. RESULTS Baseline demographic attributes were comparable between both the groups including total cholesterol and low-density lipoprotein (LDL). The mean reduction in systolic and diastolic blood pressure (BP) after 12 weeks was highly significant (P value < 0.001) in both the groups but when mean reduction in SBP & DBP was compared, there was no significant difference (P > 0.05) between the drugs. Blood levels of total cholesterol, LDL, triglyceride had significantly reduced (P < 0.05) in Telmisartan group compared to Enalapril group after 12 weeks of follow up and mean high density lipoprotein (HDL) level significantly increased in Telmisartan group (P < 0.05) but no increment was seen in Enalapril group. CONCLUSIONS Telmisartan and Enalapril had comparable antihypertensive effect and significant reduction in blood pressure was seen after 12 weeks of therapy in both the groups. In addition, Telmisartan showed more beneficial effects on lipid profile when compared to Enalapril. KEYWORDS Hypertension, Dyslipidemia, Lipid Profile, Telmisartan, Enalapril
Background: Cardiovascular diseases are one of the most important group of diseases causing premature mortality and morbidity. Dyslipidemia is an independent risk factor for cardiovascular diseases and is a disorder of lipoprotein metabolism. Various research studies support role of vitamin D against dyslipidemia. Vitamin D concentration positively correlates with HDL cholesterol and negatively with serum LDL and triglyceride levels. Vitamin D supplementation to Atorvastatin appeared to have increased cholesterol lowering activity more than either substance did alone.Methods: The study was conducted in an outpatient department of general medicine for a duration of 12 weeks in a tertiary care hospital. Total of 100 patients with dyslipidemia were selected based on measurement of lipid profile. Out of 100 patients, 50 patients under group A were treated with atorvastatin 10mg and balance 50 patients under group B treated with atorvastatin and Vitamin D3 1000 IU/day orally. Patients were followed up monthly for 3 months and lipid profile was assessed at baseline and at the end of study. The baseline characteristics were similar in both study groups.Results: On comparing groups at the end of 12 weeks mean LDL, triglycerides and VLDL were significantly reduced in group B than group A with p<0.001. The mean HDL level too increased in group B than group A with p<0.001.Conclusions: Fasting plasma lipid profile improvement was higher in the atorvastatin with vitamin D3 group compared to atorvastatin group.
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