Abstract

Introduction: Hypertension (high blood pressure) affects approximately 1 billion individuals worldwide. Epidemiological studies show a steadily increasing trend in hypertension prevalence over the last 40 years, more in urban than in the rural areas. Newer antihypertensive agents are constantly being introduced and heavily promoted. At present several Angiotensin receptor blockers (ARBs) are in use for the treatment of hypertension, heart failure and diabetic nephropathy. The newest agent in the class is Olmesartan medoxomil approved by FDA in April 2002 and widely used since then. By this study we will analyze the clinical outcome of Olmesartan medoxamil in patient with hypertension.

Objectives: To study the changes in BP, ECG and ECHO finding from baseline after giving Olmesartan.

Material & Methods: The present prospective study was carried out on 39 cases with 18-70 years age group diagnosed as hypertension (stage I and stage II - JNC7). After taking written informed consent detail history, demographic and clinical data, past medical and family history; presenting symptoms and signs; physical examination findings, BP, Hematological and Biochemical parameters ECG and ECHO findings were recorded in preformed proformas. Olmesartan 20 mg/day was given as starting dose and further increased if BP not controlled. All cases will be registered and followed up after at 3 month and 6-month. Blood pressure, ECG and, left ventricle (LV) dimensions and Left ventricular mass index (LVMI) by Echocardiography will be measured and data will be compared by appropriate statistical tests.

Result: In our study mean reduction in SBP and DBP from baseline to after three months of treatment was 6.72±7.54(P < 0.0001) and 6.94±6.16 (P < 0.0001) and after 6 months was 10.16±9.57 (P < 0.001) and 9.38±6.56 (P < 0.001).On comparison between mean LVMI at baseline (43.23%) and after 3 months (42.65%) mean reduction was 0.57±1.01(P=0.12, not significant) after 6 month (41.30%) the mean reduction was 1.93±2.10 (P=0.025, significant).

Conclusion: Olmesartan medoxomil at the recommended dose of 20 mg once daily will be effective in treatment of essential hypertension but was not effective in regression of ECG based left ventricular hypertrophy. Olmesartan medoxomil after treatment reduced the left ventricular mass index which was statistically significant. This study will be served as a pilot study for future research.

Keywords: Olmesartan, Hypertension, Left ventricular hypertrophy.