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Comparative evaluation of ACE inhibitors with or without statins in the treatment of essential hypertension in a tertiary care teaching hospital at Dehradun, Uttarakhand

Shalu Bawa, Shaktibala Dutta, Amit Varma, Hitender Kumar, Mirza Atif Beg, Mohammad Anjoom.

Abstract
Background: The beneficial effects of statins on the vasculature are present early after statin administration and appear to be independent of their cholesterol-lowering actions. The pleiotropic effects of statins have prompted this study to evaluate their role in hypertension.

Objective: To compare the antihypertensive effects of ACE inhibitors either alone or in combination with statins in a tertiary care teaching hospital at Dehradun, Uttarakhand.

Materials and Methods: The study was conducted in 20 hypertensive patients by the Pharmacology Department in Medicine OPD at Shri Guru Ram Rai Institute of Medical and Health Sciences (SGRRIM & HS), Dehradun, for 1 year from January 2012 to December 2012. Initially, patients were stabilized for 4 weeks by ACE inhibitors and then subdivided into two groups. Group I: ACE inhibitors (n = 10) and Group II: ACE inhibitors + statins (n = 10). Patients were followed up every 4 weeks for 16 weeks. Systolic blood pressure (SBP), diastolic blood pressure (DBP), waist hip ratio (WHR), and body mass index (BMI) were done every visit. Lipid profile was done at 4 and 16 weeks. Primary end points were changes in SBP and DBP. Secondary end points were changes in BMI, WHR, and lipid profile. Analysis was done by paired and unpaired t test. p ≤ 0.05 was significant.

Results: At 4 and 16 weeks, SBP in Group I was 131.6 3.42 and 123.8 2.24 mmHg (p < 0.05) and in Group II was 138.2 3.13 and 126 1.86 mmHg (p < 0.01), respectively. At 4 and 16 weeks, DBP in Group I was 84.4 1.17 and 80.4 0.41 mmHg (p < 0.05) and in Group II was 85.6 1.58 and 81.8 0.91 mmHg (p < 0.05), respectively. At 16 weeks, intergroup SBP and DBP comparison was done, which was not significant (p > 0.05).At 4 and 16 weeks, lipid profile in Group I was insignificant (p > 0.05), in Group II was significant (p < 0.05). Both BMI and WHR in Groups I and II at 4 and 16 weeks were insignificant (p > 0.05).

Conclusion: Both groups showed significant improvement in SBP and DBP. But no significant difference was seen on intergroup comparison at the end of the study period. Longer-duration studies with larger sample size are needed to establish the role of statins in hypertension.

Key words: ACE inhibitors, statins, hypertension, body mass index, waist hip ratio



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