Assesslnent of Therapeutic Efficacy of Anti-Hypertensive and Anti-Diabetic Drugs in Hypertensive Macroalbuminuric Type II Diabetic Patients

Abstract

The present prospective study was on 95, type 11 diabet ic subj ects registered at Rawalpindi General Il ospit <t1 . R<lw<t1pinlii . The suhj ects se lected were ha th males and females aged 35 - 75 years with known hypertension and macroalbuminuria. The study was designed to assess th e effi cacy of five different a ntihypertensive and two hypoglyceamie drugs in preventing the development of diab etic nephropathy and limiting its progression. All subjects were either on ACE inhibitors, tenormin, ACE inhibitors + ARB's, nOl'vasc or capotin for hypertension and diaonil and glu eophage or a co mbination of di aonil + glucophage for hyperglyceamia, The subj ect status was assessed through blood pressure, renal function tests, blood sugar random and lipid proli le. The subj ec ts were anal yzed age-wise, gender-wise and drug-wise. All sllhj ee ts were il ypert cii sive, Ill 'lel'llalhulllinuric <lnd hyperglycca mi c, even tilougil tlley were on drug treatment va lues 0 r a II parameters were above the normal levels. None 0 f th e subj eets showed conlrol over bl ood sugar random, blood pressure and renal function tests. Better response to drugs was the outcome in male subj ects aged 49 - 61 years. Their BMI (P<O,004), serum urea (P<{).03) and serum creatinine (P<O.003) were significantly lower. In other age groups th ere was no difference between the two genders. On drug-wise comparison it was observed that ACE inhibitors were a better choice as compared to other ant ihypertensive agents. ACE inhibitors controlled the systolic blood pressure (P<O.OO I), blood sugar random (P<O.029), serum urea (P<O.OOl), serum creatinine (p<O.005) and. serum potassium (P<O.OOG), signi fi cantly, in comparison with other antihypertensive drugs. Hypoglycealllic drugs behaved in a simil ar manner, These observati ons suggest thal ACE inhibitors lowered the renal funeion tests and can limit the progress ion of nephropathy, Quantifi cation predicts the risk of disease progression. ACE inhibitors had renoprotect ive and as well as antihypertensive effect. The study therefore is a step forw ard but still leaves the question unanswered about renoprotective effect of ACE inhibitors,