Abstract
Objective: To analyse the effect of fixed dose combination therapy with Olmesartan/Amlodipine in the treatment of Resistant Hypertension. Design: Questionnaire based cross sectional study. Method: The study was carried out among 364 patients admitted with history and 24 hour holter blood pressure monitor evidence for Resistant Hypertension in the Department of Cardiology between 1 st January 2012 and 31 st January 2015. Patients with history of Resistant Hypertension were screened with 24 hour holter blood pressure monitoring and those who fullfilled the criteria for Resistant Hypertension according to the ESC guideline for Management of Arterial Hypertension based on the treatment history and 24 hour holter blood pressure monitoring were included in the study after obtaining informed consent. Patients included in the study were started on therapy with Olmesartan/Amlodipine at fixed dose combination along with diuretic and Beta-Blocker. Patients were continued on this fixed dose combination therapy for 3 months. After the 3 month period patients were reassessed with control holter blood pressure monitoring to access the efficacy of the treatment and the circadian control of arterial blood pressure. Result: From the study it was observed that 68.68% patients (250 of 364) had reached optimal control of arterial blood pressure by the fixed dose combination therapy with Olmesartan/Amlodipine. 17.04% patients (62 of 364) had non optimal control of arterial blood pressure and 8.79% patients (32 of 364) continued to be with resistant hypertension in-spite of the maximal dosage of the fixed dose combination therapy with Olmesartan/ Amlodipine. 5.49%- patients (20 of 364) discontinued the treatment due to pedal edema. We observed from the screening holter blood pressure monitoring that 29.94% - patients (109 of 364) with resistant hypertension were non-dippers and after the fixed dose combination therapy with Olmesartan/Amlodipine only 10.44% patients (38 of 364) were non-dippers. Conclusion: The study revealed that fixed dose combination therapy with Olmesartan/Amlodipine in patients with Resistant Hypertension has high efficacy and minimal side effects with good circadian control of arterial blood pressure.
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