Outcome of Labetalol and Methyldopa as Oral Antihypertensive Agent in the Treatment of Pregnancy Induced Hypertension

Mediscope ◽  
2021 ◽  
Vol 8 (1) ◽  
pp. 19-26
Author(s):  
Kakali Rani Ghosh ◽  
Shamima Akhter ◽  
Adhir Kumar Das ◽  
Naznin Naher ◽  
Suma Rani Paul ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Side Effects ◽  
Antihypertensive Drugs ◽  
Treated Group ◽  
Mean Blood Pressure ◽  
Pregnancy Induced Hypertension ◽  
Mortality And Morbidity ◽  
Induced Hypertension ◽  
Group A ◽  
Group B

Background: In a developing country like Bangladesh pregnancy induced hypertension is an important medical problem and a major cause of maternal and perinatal mortality and morbidity. Antihypertensive drugs are often used to lower blood pressure and also help in reducing maternal and fetal complications. Objective: To compare the efficacy and safety of labetalol and methyldopa in management of pregnancy induced hypertension. Methods: A total of 100 patients having newly onset hypertension during pregnancy were taken and divided randomly into two groups. Group A was given labetalol and group B methyldopa. In both groupsmean blood pressure was measured on 1stday as pretreatment and at 48th hour and 8th day as post-treatment measurement, total dose of each drug require per day and side effects were recorded.Reduction in blood pressure, doseand side effects were compared. Results: Labetalol treated group of patients showed significant fall in mean blood pressure from 1st day to 48th hour and 1st day to 8th day.In patients treated with labetalol mean blood pressure on 1st day was 123.9 ± 17.11 mmHg and was controlled to 100.03 ± 6.38 mmHg on 48th hour and 94.13 ± 4.3 mmHg on day 8, while in methyldopa treated group on 1st day was 121.23 ± 13.597 mmHg which was reduced to 105.8 ± 6.53 mmHg on 48th hour and 97.96 ± 4.11 mmHg on day 8.The mean drug dosage required to control BP in group A was 380 ± 259.5 mg and in group B was 1540 ± 503.45 mg. Group A had less side effects. Conclusion: Labetalol is safe more efficacious and quicker control of blood pressure withless maternal adverse effects and thus advantageous over methyldopa. Mediscope Vol. 8, No. 1: January 2021, Page 19-26

scholarly journals Oral Nifedipine Versus Intravenous Labetalol in the Management of Severe Pregnancy Induced Hypertension: A Randomized Control Trial

2021 ◽  
Vol 20 (1) ◽  
pp. 55-61
Author(s):  
Farah Naz Mabud ◽  
Serajun Noor ◽  
Shahanara Chowdhury
Keyword(s):  
Blood Pressure ◽  
Side Effects ◽  
Mode Of Delivery ◽  
Multiple Pregnancy ◽  
Drug Dose ◽  
Time Interval ◽  
Pregnancy Induced Hypertension ◽  
Induced Hypertension ◽  
Group A ◽  
Group B

Background : Pregnancy-also known as gestation is the time during which one or more offspring develops inside a woman. A multiple pregnancy involves more than one offspring, such as with twins. Pregnancy usually occurs by sexual intercourse, but can occur through assisted reproductive technology protedures. To assess the efficacy of oral Nifedipine and I/V Labetalol for lowering BP in severe PIH after 28 weeks of pregnancy. Materials and methods: In this study 100 subjects were selected with severe pregnancy induced hypertension as per inclusion criteria. After taking informed written consent they were randomly allocated into two groups, A & B. Group A received initially tablet nifedipine 10 mg orally with repeated doses of 20 mg every 20 minutes upto five doses while Group B received intravenous labetalol 20 mg initially followed by escalating doses of 40, 80, 80 and 80 mg every 20 minutes until the therapeutic goal blood pressure Systolic £ 150 mmHg & diastolic £ 100 mmHg was achieved. Primary outcomes were the time interval and the number of doses needed to achieve a blood pressure of £ 150/100 mmHg, Secondary outcomes were fetomaternal safety, efficacy and side effects of both drugs. The outcomes were recorded in a preformed data collection sheet. All the data were analyzed by computer based software SPSS version 19 (SPSS Inc, Chicago, IL, USA). P <0.05 at 95% level was taken as statistically significant. Results: A total of 100 patients of different ages with mean age of 27.41 years were taken in the study. Primi patients were more in Group A the Group B and mode of delivery was commonly caesarian section (66% vs 78%) in both groups. Proportion of target BP achievement were 100% in Group A and it was 72% in Group B. Need of drug dose and time of reduction was found significantly less among Group A women. Change of mean ± SD, SBP was more rapid in Group A ( 174.90 ± 20.01 vs 158.40 ± 11.13) women who were on Group A oral nifedipine than Group B ( 179.80 ± 16.54 vs 167.40 ± 15.02) i/v labetalol group after first dose. It was same for DBP also. Need of mean dose were less in group A than Group B (1.72 vs 3.30) also total time needed to achieve target BP was less in Group A (34.40 vs 66.0 mins). There was no need of doses exceeding third dose who were on oral nifidipine than i/v labetolol. Both maternal and fetal heart rate was not influenced by both the drugs. Side effects of drugs were found more in Group B (8% vs 4%) and fetal death also more common in there (8% vs 16%). Value of APGAR scores was found higher both at 1 minute and at 5 minutes among Group A neonates than Group B. Significant urine output volume was found in Group A patients than Group B at first hour. Conclusion: Oral nifedipine and intravenous labetalol both the regimens are found to be effective in the management of severe PIH. But Nifidipine lowers blood pressure more rapidly with fewer doses with minimum fetomaternal side-effects. Chatt Maa Shi Hosp Med Coll J; Vol.20 (1); January 2021; Page 55-61

scholarly journals PREGNANCY INDUCED HYPERTENSION

2016 ◽  
Vol 23 (10) ◽  
pp. 1187-1193
Author(s):  
Nadia Sharif ◽  
Irum Usman ◽  
Tasneem Azhar
Keyword(s):  
Blood Pressure ◽  
Mean Blood Pressure ◽  
Outpatient Basis ◽  
Pregnancy Induced Hypertension ◽  
Hypertensive Disorders Of Pregnancy ◽  
Normal Limits ◽  
Hypertensive Disorders ◽  
Group I ◽  
Induced Hypertension ◽  
Group A

Introduction: The hypertensive Disorders of pregnancy are major contributors tomaternal and perinatal morbidity and mortality. The aim of hypertensive therapy is to preventcomplications associated with hypertensive disorders of pregnancy. Objective: To compareefficacy of methyldopa and labetalol in management of pregnancy induced hypertension.Study Design: Randomized control trial. Setting: Punjab medical college and affiliatedhospitals Faisalabad. Methods: Patient were be randomly assigned to either group A or Groupby lottery method. Each group included 157 patients. In group A: labetalol was started at 100mg three or four times a day and increased up to 1200 mg a day in divided doses. In group B:methyldopa was started at 250mg per day 3 to 4 divided doses and increased up to 500 mg in 3to 4 divided doses. Blood pressure was recorded by sphygmomanometer. Blood pressure wasrecorded after 48 hours and then weekly till term on outpatient basis. Results: The treatmentof methyldopa in group I was proved to successful in lowering the mean blood pressure andmaintaining mean blood pressure within normal limits in 142 of 155 patients. It can be said itwas successful in 91.61% cases. 8.39% cases progressed to severe hypertension or eclampsiabecause methyldopa was unsuccessful to prevent progress of disease. Conclusion: It isconcluded that antihypertensive therapy such as methyldopa and labetalol are successful inlowering blood pressure in patient with pregnancy induced hypertension.

scholarly journals Study of labetalol vs. methyldopa in treatment of pregnancy induced hypertension

2019 ◽  
Vol 8 (6) ◽  
pp. 2378
Author(s):  
Bhakti G. Gurjar ◽  
Samidha S. Malewar
Keyword(s):  
Blood Pressure ◽  
Treated Group ◽  
Medical Problem ◽  
Adverse Outcomes ◽  
Medical College ◽  
Increased Risk ◽  
Induced Hypertension ◽  
Single Centre Study ◽  
Group A ◽  
Group B

Background: Hypertension is a common medical problem encountered during pregnancy and is associated with increased risk of adverse outcomes. Objective of this study was to compare efficacy and safety of Labetalol and Methyldopa in controlling blood pressure in patients with PIH and pre-eclampsia.Methods: A comparative, prospective observational, single centre study conducted from November 2015 to November 2017 in women with PIH at Indira Gandhi Government Medical College, Nagpur. Group A included 100 patients treated with Labetalol while Group B included 100 patients who were given Methyldopa. Response in lowering of BP was assessed over a period of 7 days.Results: Labetalol treated group of patients showed significant fall from 143.50±7.30mmHg/101.30±3.93 (sytolic/diastolic) on 1st day to 126.10±5.49 mmHg/87.40±5.62 mmHg (sytolic/diastolic) on day 7, while systolic/diastolic BP in methyldopa group on 1st day was 145.20±7.17 mmHg/101.60±4.20 mmHg which was reduced to 129.20±4.86 mmHg/90.50±3.30 mmHg on day 7. Author found that MAP in Labetalol group reduced from 115.226±4.17 mmHg to 100.17±4.43 mmHg on day 7 while in Methyldopa group had MAP on admission 115.99±4.38 mmHg and on day 7 it reduced to 103.27±2.99mmHg which is highly significant.Conclusions: Labetalol controls systolic and diastolic blood pressure more rapidly and effectively than Methyldopa. Safety profile and adverse effects of Labetalol and Methyldopa are similar to each other.

scholarly journals COMPARISON OF INTRAVENOUS LABETALOL AND ORAL NIFEDIPINE IN MANAGEMENT OF BLOOD PRESSURE IN PATIENTS WITH SEVERE PREGNANCY INDUCED HYPERTENSION

2019 ◽  
Vol 10 (4) ◽  
pp. 26-30
Author(s):  
Tehseen Aslam ◽  
Nuzhat Parveen ◽  
Shakeela Irfan ◽  
Uzma Riaz ◽  
Amin Anjum
Keyword(s):  
Blood Pressure ◽  
Blood Pressure Control ◽  
Pressure Control ◽  
Pregnancy Induced Hypertension ◽  
Achieve Blood Pressure Control ◽  
Achieve Blood Pressure ◽  
Induced Hypertension ◽  
Group A ◽  
Group B ◽  
Mean Time

ABSTRACT:It is estimated that 6-12% of all the pregnancies are complicated by hypertension and even all improvements pre eclempsia is a significant reason of maternal and perinatal morbidity and mortality worldwide. Nifedipine, Labetalol and hydralazine are mostly being used in acute management of hypertension in pregnancy but so far there is no evidence that anyone drug is more effective. OBJECTIVE: To compare the mean time to achieve blood pressure control of oral Nifedipine with intravenous Labetalol for management of severe pregnancy induced hypertension. METHODOLOGY: This randomized control trial was done in Obstetrics and Gynaecology department of Hilal-e-Ahmer hospital, Faisalabad over a period of 6 months from 01-07-2016 to 31-12-2016. Total 100 patients (group-A and group–B having 50 in each) were included in study. In group A, females were given 40mg oral Nifedipine and in group, females were given 20ml intravenous Labetalol. Time at administration was followed in the ward for assessment of blood pressure control. Blood pressure was noted after every 10 min. The total donation time to achieve B.P was noted (as per operational definition).The collected data was analyzed by using SPSS version 17.0. Baseline blood pressure were presented in the form of mean+SD. Both groups were compared for mean time to achieve blood pressure control by applying t- test and consider significant at p value <5%.RESULTS: Patients were ranged between 20-40 years. Mean age of the patients was calculated as 26.98+4.54 and 27.36+4.43 years in group-A and B respectively. Gestational age shows that 64%(n=32) in Group-A 74%(37%) in Group–B were between 20-30 weeks of gestation while 36%(n=18) in Group-A were between 31-40 weeks of gestation mean±SD was calculated as 28.92+4.91 and 28.94+4.72 weeks in Group-A and B respectively. Mean time to achieve B.P control in group A was 31.24+5.62 and in group B 45.5+4.63 with p value <0.05. CONCLUSION: Mean time to achieve blood pressure control was shorter with oral Nifedipine when compared to I/V Labetalol for management of female presenting with severe pregnancy induced hypertension. 

scholarly journals TO COMPARE THE EFFICACY OF LABETALOL AND METHYLDOPA IN TREATMENT OF PREGNANCY INDUCED HYPERTENSION

2020 ◽  
pp. 54-55
Author(s):  
Ashish Yadav ◽  
Rohitash Kularia ◽  
Subash Chandra ◽  
Anita Sharma
Keyword(s):  
Antihypertensive Drugs ◽  
Pregnancy Induced Hypertension ◽  
Inclusion Criteria ◽  
Hypertension In Pregnancy ◽  
Induced Hypertension ◽  
Group A ◽  
The Mean ◽  
Group B ◽  
Labour Room ◽  
New Onset

Background- The present study is undertaken with limited available facilities to find out the efficacy of two oral antihypertensive drugs namely labetalol and methyldopa in management of pregnancy induced hypertension. Methods- The study consisted of 100 patients with pregnancy induced hypertension attending outpatient department and admitted in ANW, or who directly came to labour room. These patients were randomly selected on lottery basis after they fulfilled the inclusion criteria. Total 100 patients were taken for the study and divided into 2 groups of 50 patients in each group. Results- The mean SBP before treatment in methyldopa group was161.33 ± 8.97 mmHg and 160.03 ± 8.23 mmHg in labetalol group which showed a fall to 138.61 ± 6.67 mmHg (methyldopa group) and 138.08 ± 5.37 mmHg (labetalol groups) after treatment. Fall of SBP was significant in both the groups. But inter group difference was not significant (p > 0.05). The mean DBP before treatment was 106.85 ± 4.33 mmHg in methyldopa group and 105.63 ± 5.23 mmHg in labetalol group which decreased to 89.31 ± 6.51 mmHg and 89.68 ± 5.26 mmHg respectively after treatment. Fall of DBP was significant in both the groups. But inter group difference was not significant (p > 0.05). Fall of MAP was significant in Group A and Group B. But inter group difference was not significant (p > 0.05). Conclusion-Labetalol and methyldopa are equally efficacious in controlling blood pressure in new onset hypertension in pregnancy.

scholarly journals Comparison between methyldopa and combination of methyldopa and nifedipine in terms of mean change in blood pressure in pregnancy induced hypertension

2021 ◽  
Vol 15 (7) ◽  
pp. 1703-1705
Author(s):  
Bilqees Akhtar Malik ◽  
Shahzad Bashir Momina ◽  
Tazeen Ashraf
Keyword(s):  
Blood Pressure ◽  
Diastolic Blood Pressure ◽  
Gestational Age ◽  
Low Dose ◽  
High Dose ◽  
Pregnancy Induced Hypertension ◽  
Induced Hypertension ◽  
Group A ◽  
Group B ◽  
In Pregnancy

Objective: Comparison between Methyldopa and combination of Methyldopa and Nifedipine in terms of mean change in blood pressure in pregnancy induced hypertension. Material and methods: This randomized controlled trial was conducted at Department of Obstetrics and Gynecology, Combined Military Hospital Bahawalpur from February 2020 to August 2020 over the period of 6 months. Total 80 patients with pregnancy induced hypertension as per operational definition having age 20-40 years and having gestational age ≥ 20 weeks assessed on LMP were selected. Results: Mean age of the patients was 30.81 ± 5.670 years, mean age of patients of group A was 31.50 ± 5.809 years and mean age of group B was 30.13 ± 5.515 years. Mean gestational age was 30.17 ± 5.981 weeks, mean gestational age of patients of group A was 29.70 ± 6.329 weeks and mean gestational age of patients of group B was 30.65 ± 5.65 weeks. In group A, mean diastolic blood pressure was decrease from 101.2250 ± 4.97938 to 84.5000 ± 3.26599 and in group B from 107.7750 ± 7.18434 to 82.5000 ± 2.25320. Comparison of mean decrease in diastolic blood pressure between group A (High dose Methyldopa) and group B (Low dose Low dose Methyldopa with Nifedipine) was done. Mean decrease in diastolic blood pressure in group A was 16.72 ± 3.935 and in group B was 25.28 ± 6.876. Statistically significant difference of mean decrease in diastolic blood pressure between the both groups was noted with p value 0.000. Conclusion: Results of this study showed that Low dose Methyldopa with Nifedipine combination is more effective as compared to High dose Methyldopa to reduce diastolic blood pressure in pregnant women suffering from pregnancy induced hypertension. Keywords: Diastolic blood pressure, Methyldopa, Nifedipine, Pregnancy induced hypertension, Systolic blood pressure

Evaluation of the Effect of Timolol Alone and in Combination with Hydrochlorothiazide and Amiloride in the Treatment of Mild to Moderate Arterial Hypertension: A Double-Blind, Controlled Study

1976 ◽  
Vol 51 (s3) ◽  
pp. 529s-531s ◽  
Author(s):  
G. Muiesan ◽  
B. Magnani ◽  
E. Agabiti-Rosei ◽  
C. Alicandri ◽  
E. Ambrosioni ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Essential Hypertension ◽  
Side Effects ◽  
Moderate Essential Hypertension ◽  
Fixed Dose ◽  
Controlled Study ◽  
Double Blind ◽  
Combination Tablet ◽  
Group A ◽  
Group B

1. The effects of timolol alone and in combination with a fixed dose of hydrochlorothiazide and amiloride have been studied in a double-blind, controlled study in fifty-four patients with mild to moderate essential hypertension. 2. After a 4 weeks placebo period patients were randomly assigned to enter groups receiving timolol alone (group A), hydrochlorothiazide + amiloride (group B) or timolol + hydrochlorothiazide + amiloride (group C). Each treatment was carried out for 6 weeks. 3. The use of timolol (10 mg), hydrochlorothiazide (25 mg) and amiloride (2·5 mg) in a combination tablet given twice daily gave better control of blood pressure in patients with mild to moderate essential hypertension than did equivalent dosages of timolol alone or of hydrochlorothiazide and amiloride. 4. Clinical and laboratory side effects were minimal.

scholarly journals COMPARISON OF TREATMENT OUTCOME OF ANTIHYPERTENSIVE DRUGS IN THE MANAGEMENT OF PREGNANCY INDUCED HYPERTENSION

2017 ◽  
Vol 9 (3) ◽  
pp. 287
Author(s):  
Sivakumar Velusamy
Keyword(s):  
Blood Pressure ◽  
Treatment Outcome ◽  
Pregnancy Outcome ◽  
Prospective Observational Study ◽  
Antihypertensive Drugs ◽  
Drug Group ◽  
Pregnancy Induced Hypertension ◽  
Significant Difference ◽  
Specialty Hospital ◽  
Induced Hypertension

This study was aimed to find out the differences in the pregnancy outcome of PIH women treated with the antihypertensive drugs methyldopa and nifedipine. The prospective observational study was conducted in a multi specialty hospital at Coimbatore with 161 PIH diagnosed women. Women were categorised into the no-drug group, methyldopa group, nifedipine group and methyldopa with nifedipine group. All the women were monitored from diagnosis to delivery. The maternal and neonatal data were collected and analysed. The drugs were significantly controlled the blood pressure (BP) from base to end (P<0.001). There was no significant difference in the reduction of BP between the drugs. Cesarean delivery (>90%) and preterm delivery were high across all the groups. No significant difference was seen between these groups. The AGA (Average for gestational age) babies were significantly higher with a no-drug group (83%) and lower with nifedipine group (40%). Two women were reported with HELLP syndrome in methyldopa with nifedipine group. No significant difference was found in terms of pregnancy outcome between these groups except for eclampsia and AGA. Eclampsia was affected more with 14% in methyldopa with nifedipine group. We found similar outcomes; there were no significant changes between methyldopa, nifedipine, and the no-drug treatment. The antihypertensive drugs nifedipine and methyldopa both were significantly reduced the BP. The maternal and neonatal complications were similar between these two drugs. No beneficial effect can be identified one over another.

scholarly journals Epidural tramadol improves the quality of pain relief during labor

2017 ◽  
Vol 6 (3) ◽  
pp. 14-19
Author(s):  
I N Shrestha ◽  
G P Deo ◽  
S K Shrestha ◽  
S Neupane ◽  
B S Regmi
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Side Effects ◽  
Pain Relief ◽  
Total Dose ◽  
Analgesic Efficacy ◽  
Time Intervals ◽  
Group A ◽  
Group B

 To study the analgesic efficacy and side effects of Tramadol for painless labor in combination with Bupivacaine. Randomized, controlled, double blind, open prospective study conducted at Department of Obstetrics and Gynaecology, Chitwan Medical College from July 1st 2015 to June 30th 2016. 100 patients of ASA Grade I and II, aged between 20-35 years willing for epidural analgesia for labor pain were included in the study. They were divided into two groups: Group A- Control group and Group B- Study group. Subjects of Group A received 10 ml of 0.25% Bupivacaine and that of Group B received 10ml of 0.25% Bupivacaine with 1mg/kg body weight of tramadol. Analgesic efficacy was assessed by Visual Analogue Scale (VAS) and other vital parameters (Blood Pressure, Heart Rate and Respiratory Rate) before the administration of the drug and at different time intervals of 0, 5 min, 10 min, 15 min, 30 min, 45 min, 60 min and every hourly up to maximum of 5 hrs. Neonatal out comes were assessed by the use of APGAR scores and the side effects of the drugs in two groups were also evaluated. Total number of patients was 100, of ASA Grade I and II, aged between 20-35 years. The mean age of patients in Group A was 23.54 ± 3.74 years and 24.22 ± 3.64 years in Group B. Mode of delivery was spontaneous vaginal in 42 patients (84%) in group A and 45 patients (90%) in group B. Instrumental vaginal delivery was done in 1 patient (2%) of group A and none of group B. Cesarean section was done in 7 patients (14%) of group A and 5 patients (10%) of group B. There was no significant difference in heart rate, blood pressure and respiratory rate at various time intervals. Pain score of Group B was significantly less at 60th min and had lower values than Group A at various time intervals. Time for first top up was significantly delayed and the total dose of bupivacaine was significantly lower in Group B patients but the incidence of nausea and vomiting was significantly high among Group B patients. At one minute majority of the babies of group A had mean APGAR score 6.98 ± 0.55 versus 7.18 ± 0.60 in group B. At 5 minute, Group A had mean score of 8.02 ± 0.47 versus 8.22 ± 0.58 in Group B. There were no significant differences in 2 groups. In both the groups there was no significant effect on duration of second stage of labor and it wasn’t prolonged in any of the patients. Epidural anesthesia with bupivacaine and tramadol provided better pain relief and reduced the total dose of bupivacaine in majority of the patients with no adverse effects on mother and fetus. As tramadol is cheap, safe and effective, it can be considered as a better option to improve quality of pain relief during labor.

scholarly journals CONTROL OF HYPERTENSION

2010 ◽  
Vol 17 (03) ◽  
pp. 425-430
Author(s):  
GHULAM RASOOL BHURGRI ◽  
HUSSAIN BUX KOREJO ◽  
MUHAMMAD ALI QURESHI ◽  
Raj Kumar ◽  
Nasrullah Aamir
Keyword(s):  
Blood Pressure ◽  
Side Effects ◽  
Combination Therapy ◽  
Systolic Blood Pressure ◽  
Diastolic Blood Pressure ◽  
Combined Therapy ◽  
Group A ◽  
The Difference ◽  
Group B ◽  
Age Range

Objective: To compare the efficacy and tolerability of Losartan and Atenolol in alone and combination in treatment of hypertension. Study Design: Comparative study. Setting: Medical out patients department of Jinnah Postgraduate Medical Centre Karachi from January 2007 to June 2007. Methods: There were 60 patients previously untreated with mild and moderate essential hypertensions were registered for study. The selected patients were divided into three groups. Group A was given atenolol, Group B was given Losartan, and Group C was given both drugs. The target blood pressure was 120-140/80-90 mmHg. There were 42 males and 18 females with age range 25-65 years. Results: The mean baseline score of groups A, B and C were showed systolic blood pressure 182±19, 174 ± 20 and 168 ± 12 respectively. The diastolic blood pressure was 104.5±11, 102.5±9 and 104.5±10 respectively. The difference in mean systolic and diastolic blood pressure was not significant statistically as P = 0.06 and 0.76 respectively. After 4 months of treatment with atenolol, systolic blood pressure decreased to 147±17, and diastolic blood pressure fell to 87±4. Losartan decreased systolic blood pressure 138±13 and diastolic blood pressure 87±4 in 4 months of treatment. The combined therapy decreased systolic blood pressure 115±4.6 and diastolic blood pressure 75±4.7. The effect of treatments on systolic and diastolic blood pressure was significantly different as (p < 0.001) and ( p = 0.036) respectively. Side effects observed in 2 (10%) patients from group C, 8 (40%) in group A and 4 (20%) in group B. Combination therapy proved more effective in controlling hypertension than mono therapy and also fewer side effects. Patients showed better control on combination therapy as compared to mono therapy. Losartan proved a little better in controlling hypertension then atenolol and was more expensive. Conclusion: Patients showed better results with combination therapy for hypertension compared to individual drug.

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