Study of Changes in Renal Function by Perindopril and Telmisartan during Treatment of Systemic Hypertension.

Abstract

Angiotensin Converting Enzyme Inhibitors (ACEI) and Angiotensin Receptor Blockers (ARBs) has been a major therapeutic advance in the management of hypertensive patients. This study was designed to compare adverse effects on renal markers in treatment with two commonly used drugs Perindopril and Telmisartan in cases of Hypertension. This was an 'observational' and 'cross-sectional' study. This study was conducted in two groups, Group A (Newly diagnosed hypertensive patients) and Group B (Old but poorly controlled hypertensive), each had 100 patients. In both groups, half the patients were given Perindopril 4 mg OD and half were given Telmisartan 40 mg OD for 24 weeks. If blood pressure was not controlled, dose was titrated to response and increased to 8 mg OD and 80 mg OD for Perindopril and Telmisartan respectively to keep mean arterial pressure between 90-115 mmHg. The adjusted dose was kept constant in both groups. Blood urea, serum creatinine and creatinine clearance was estimated initially and then at 4(th), 12(th) and 24(th) week. Treatment with Perindopril showed that mean baseline values for blood urea, serum creatinine and creatinine clearance in newly diagnosed and old hypertensive patients were 30.88, 1.37, 64.09 and 33.68, 1.53, 55.98, respectively. After study period these values were 32.24, 1.40, 63.97 and 29.80, 1.46, 59.23 respectively (p value > 0.05). Treatment with telmisartan showed that mean baseline values of blood urea, serum creatinine and creatinine clearance in both group of patients were 30.88, 1.52, 59.31, and 31.72, 1.40, 65.67, respectively. After treatment these values in both groups were 31.92, 1.43, 62.66; and 32.20, 1.46, 61.70, respectively (p value > 0.05). It concluded that both Perindopril and Telmisartan significantly reduces systolic, diastolic and mean arterial pressure without any significant effect on renal function in both newly diagnosed and old hypertensive patients.