BLOOD PRESSURE REDUCTION WITH 3 FIXED- SINGLE PILL COMBINATION TREATMENTS OF RAS-BLOCKERS PLUS CCB AMONG PREDIABETIC HYPERTENSIVE PATIENTS. A RANDOMIZED 12-WEEK OPEN-LABEL STUDY

Abstract

Objective: The effect of various antihypertensive drugs on both SBP and DBP levels has been studied extensively. Dual combination treatment is advised with current guidelines as first treatment step. Herein, we present comparative data of the effect of delapril/manidipine versus valsartan/amlodipine versus telmisartan/amlodipine combination treatments on blood pressure levels, before and after a 12-week treatment, in hypertensive prediabetic patients. Design and method: Data were collected from 158 patients from the outpatient clinic for patients with lipid disorders, hypertension and diabetes of our hospital, during the period 2014-2018 with stage II arterial hypertension and prediabetes. A total of 53 patients was randomized in the delapril/manidipine group 30/10 mg per day while 51 persons had been randomized in the group of telmisartan/amlodipine 80/5mg per day and 54 patients in the valsartan/amlodipine 160/5 mg per day. All patients successfully completed the study. Baseline characteristics are presented in Table 1A. Results: The resulting alternations on BP levels, before and after the 12-week treatment are presented on Table 1B for the 3 treatment groups. Conclusions: there was a statistically significant difference observed in SBP levels, at the end of the 12-week treatment, for each treatment group (p-value<0,001) with a change of -18 mmHg for DEL/MANI treatment group (reduction rate: -11.54%), -24 mmHg for TEL/AMLO treatment group (decrease rate of -14.72%) and -22 mmHg for VAL/AMLO treatment group (reduction rate: -13.58%). DBP levels showed a significant difference at the end of the treatment, for each group (p-value<0,001) with a change of -12 mmHg for DEL/MANI treatment group (reduction rate:-12%), -15 mmHg for TEL/AMLO treatment group (reduction rate: -15%) and -13 mmHg for VAL/AMLO treatment group (reduction rate: -13%). In comparison between treatment groups, a statistically significant difference was observed in the change of SBP levels from the start of treatment to its end, for DEL/MANI treatment group, compared to VAL/AMLO (p-value<0.05) as well as compared to TEL/AMLO treatment group (p-value <0001). The smallest decrease in SBP levels was observed In DEL/MANI treatment group, of all the 3 treatment groups.