Evaluation of efficacy and safety of cilnidipine and losartan in hypertensive patients with type 2 diabetes mellitus

Abstract

Objective: To compare the efficacy and safety of cilnidipine and losartan in hypertensive patients with type 2 diabetes mellitus (type 2 DM). Materials and Methods: In this observational, prospective study, hypertensive patients with type 2 DM receiving cilnidipine and losartan were included. Demographic details, clinical history, serum potassium, and urinary albumin were recorded in a case record form. Patients were followed up every monthly up to 24 weeks and observed for clinical and laboratory parameters and adverse drug reactions (ADRs). Data were analyzed using paired t-test, unpaired t-test, and Fisher's exact test. Results: Out of 114 patients, 59 received cilnidipine and 55 patients received losartan. By 24 weeks, both cilnidipine and losartan significantly (P < 0.01) improved mean blood pressure and urinary albumin. However, mean decrease in urinary albumin was significant (P < 0.005) with cilnidipine (20.6 ± 20.4 mg/day) as compared to losartan (18.3 ± 14.3 mg/day). Mean serum potassium was increased significantly (P < 0.05) in patients treated with losartan (0.9 ± 2.8) as compared to patients treated with cilnidipine. A total of 19 ADRs were observed in both groups and out of these, 36.8% ADRs were caused by cilnidipine and 63.2% ADRs by losartan. Conclusion: Cilnidipine is equally effective as losartan in reducing blood pressure in hypertensive patients with type 2 DM. However, cilnidipine is more effective in the prevention of albuminuria and better tolerated by patients as compared with losartan.