To compare amlodipine with cilnidipine on antihypertensive efficacy and incidence of pedal edema in hypertensive individuals. This was a three months prospective, observational study done at the tertiary care center of Karnataka, India. A total number of 60 (n = 60) newly diagnosed hypertensives (≥140/90) of either gender, attending outpatient department of medicine, were included in the study. Out of 60 patients, 30 patients who have been prescribed tablet amlodipine 5–10 mg/day and the other 30 who have been prescribed tablet cilnidipine 10–20 mg/day orally by the consulting physician, depending upon the severity of hypertension were followed every fortnight, screened for the presence of pedal edema and blood pressure control over a period of 3 months. Antihypertensive efficacy between two groups was compared by unpaired t-test and incidence of pedal edema was compared by Fisher's exact test. Of 30 patients in the amlodipine group, 19 patients presented with pedal edema (63.3%) and 2 patients (6.66%) in cilnidipine group presented with pedal edema during the study period. There was a significant difference in the incidence of pedal edema between amlodipine and cilnidipine group (P < 0.05), but no significant difference was found in the antihypertensive efficacy of amlodipine and cilnidipine (P > 0.05). Both amlodipine and cilnidipine have shown equal efficacy in reducing blood pressure in hypertensive individuals. But cilnidipine being N-type and L-type calcium channel blocker, associated with lower incidence of pedal edema compared to only L-type channel blocked by amlodipine.
Objectives: To analyze utilization of antihypertensive drugs in chronic kidney disease patients in a tertiary care hospital. Materials and Methods: A descriptive prospective study was conducted in the dialysis unit of Bapuji hospital, Davangere during 6 month period in 2013 with stage III to V of chronic kidney disease patients. Data from case record of all patients was collected, relevant information entered in a preformed proforma and analyzed. Results: Total of 120 case records were analyzed, 30 % patients were 51-60 years, 27 % patients were 61-70 years and male to female ratio of 74: 26. Out of 120 patients, 54 patients (45 %) were diabetic with hypertension and 66 patients (55 %) were nondiabetic with hypertension. In diabetic patients with hypertension, 66.6 % were two drugs combinations, cilnidipine and torsemide (52%), amlodipine and furosemide (28%) metoprolol and cilnidipine (11%). 30% with three drug combinations. Nondiabetic patients with hypertension, 55 % had three drugs combinations, Metroprolol, furosemide, prazosin (45%), Cilnidipine, torsemide, prazosin (33 %) and 45 % two drugs combinations, amlodipine, furosemide (46%) and metoprolol, torsemide (33%) were commonly used. Conclusion: Combination of diuretic and calcium channel blockers (80 %) was commonly used in hypertensive patients with diabetic. Beta blocker because of its known adverse effects in diabetic patients (hypoglycemic unawareness) is getting less commonly used than in nondiabetic. Use of antihypertensive drugs such as selective beta blocker, alpha-blocker, Calcium channel blocker combination (45 %) more commonly used in nondiabetic with hypertension.
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