COMPARATIVE EFFICACY OF ANTIHYPERTENSIVE DRUGS AMONG ADULTS WITH CHRONIC KIDNEY DISEASE IN A TERTIARY CARE HOSPITAL

Abstract

Background:
Hypertension (HTN) is a leading contributor to chronic kidney disease (CKD) globally and a significant modifiable risk factor for both cardiovascular and renal complications. Effective blood pressure (BP) control is essential in managing CKD, yet the comparative efficacy of different antihypertensive agents remains an area of active research.

Objective:
To evaluate and compare the antihypertensive efficacy of telmisartan and amlodipine in adult patients with CKD attending a tertiary care hospital.

Methods:
A prospective, randomized, comparative study was conducted over a six-month period involving 88 hypertensive patients with CKD. Participants were randomized into two groups: Group A received telmisartan 40 mg once daily, while Group B received amlodipine 10 mg once daily. Systolic blood pressure (SBP) and diastolic blood pressure (DBP) were recorded at baseline and after six months. The primary endpoint was the mean change in SBP and DBP. Data were analysed using Student’s t-test, with a p-value of <0.05 considered statistically significant.

Results:
Both treatment groups exhibited significant reductions in BP from baseline. However, telmisartan was associated with a more pronounced reduction in SBP (−30.9 ± 7.4 mmHg vs −2.0 ± 8.5 mmHg, p = 0.0424) and DBP (−21.9 ± 4.1 mmHg vs −2.2 ± 6.3 mmHg, p = 0.0148) compared to amlodipine. No serious adverse events were reported during the study.

Conclusion:
Telmisartan demonstrated superior antihypertensive efficacy compared to amlodipine in patients with CKD, highlighting the potential preference for angiotensin receptor blockers (ARBs) as first-line agents in this population. Further large-scale, long-term studies are recommended to validate these findings.