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A comparative study to evaluate the efficacy of losartan versus atenolol in essential hypertensive patients on cardiovascular morbidity and lipid profile

Amrutha D Torvi, Soujanya S, Prashanth D, Lingraj Patil.


Background: Hypertension as a vascular disease entity is the common health problem occurring in the general population, characterized by sustained elevation of blood pressure (BP). Hypertension is one of the leading causes of the global burden of disease.

Aim and Objective: The objective of the study was: (1) To study the efficacy of losartan and atenolol in patients with hypertension and (2) To study the changes in lipid profile on treatment.

Materials and Methods: It was a prospective, open-label, parallel group, comparative study after obtaining informed consent in medicine outpatient department; 100 adult patients aged 40–60 years of either sex with newly diagnosed mild and moderate hypertensive patients were included. Patients were screened in two steps, initial clinical examination by a physician followed by required biochemical investigations includes echocardiogram (ECG), 2D ECHO, and lipid profile. Fifty patients each on LOSARTAN and ATENOLOL were randomly chosen and grouped as follows: (a) Group A – 50 patients who were prescribed Tab. losartan (50 mg/day) and (b) Group B – 50 patients who were prescribed Tab. atenolol (50 mg/day). Patients were recruited for a period of 6 months and were called for follow-up visit at the 3rd and 6th month. The collected data were entered into a specially designed pro forma (case recording form) for study.

Results: Mean age of the patients was 52.72 years with a range from 42 years to 64 years. In this study, only 3% of patients were the elderly (>60 years). About 30% of the patients had smoking and 40% of patients had alcohol history. Mean body mass index of the patients was 24.42 kg/m2 with a range from 18.9 kg/m2 to 34.6 kg/m2. Our study observed that baseline systolic (P = 0.704) as well as diastolic BP (P = 0.324) were comparable between both groups. We observed that systolic BP at 3 months was significantly lower in Group A in comparison to Group B (P = 0.007); however, diastolic BP at 3 months was comparable between both groups (P = 0.143). Both systolic (P = 0.125) and diastolic BP (P = 0.108) at 6 months were comparable between both groups. On presentation, 44% of patients in Group A and 46% in Group B had mild left ventricular hypertrophy (LVH) (P = 0.841). At 3 months, there were a significantly lesser number of patients with LVH on ECG examination in Group A in comparison to Group B (16% vs. 36%; P = 0.022). At 6 months, 12% of patients in Group A and 18% in Group B had mild LVH (P = 0.400). Our study observed that mean total cholesterol levels were comparable between both groups at baseline (P = 0.665). However, total cholesterol levels were significantly lower in Group A in comparison to Group B at 3 months (P < 0.0001) and 6 months (P = 0.027).

Conclusion: Our study observed that both losartan and atenolol are equally effective in long-term reduction of BP. However, losartan was more effective in reducing LVH in both short term and long term. In addition, losartan also significantly improved lipid profile in terms of decreasing total cholesterol, triglycerides, and low-density lipoprotein, and increasing high-density lipoprotein.

Key words: Losartan; Atenolol; Hypertension; Lipid Profile; Cardiovascular Morbidity

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