Efficacy and tolerability of trandolapril in mild to moderate hypertension--a double blind comparative clinical trial with enalapril in Indian population.

Several large scale clinical trials have demonstrated that angiotensin converting enzyme inhibitors offer cardiovascular and renal protection independent of their effects on systolic BP. Trandolapril is a new angiotensin converting enzyme inhibitor approved for the treatment of hypertension. The potential advantages of this drug are long duration of action and better tolerability. The objective of the study was to compare the efficacy and tolerability of trandolapril with that of enalapril in mild to moderate hypertension in Indian population. In this double blind, multicentric, parallel comparative clinical study, 120 patients with mild to moderate hypertension were randomly assigned to receive trandolapril 2 mg or enalapril 5 mg once daily for 8 weeks. The attainment of sitting diastolic blood pressure <90 mmHg at the end of 8th week was considered as primary outcome measure and attainment of diastolic blood pressure <90 mmHg or reduction of at least 10 mmHg diastolic blood pressure compared to baseline at any visit was considered as secondary outcome measures. 98.4% patients treated with trandolapril and 92.6% patients treated with enalapril fulfilled the primary outcome measure. 54, 72 and 62% patients on trandolapril and 52, 61 & 64% patients on enalapril fulfilled secondary outcome measure at the end of 2nd, 4th and 8th week respectively. Also trandolapril was better tolerated than enalapril with no significant abnormality in lab parameters.

Drug Utilization in Geriatric Population im a Tertiary.

One hundred and fi fty-two prescriptions of patients aged more than 65 years were picked up from in-patients of ollr hospital and analysed for drug utilization pattern. The mean age of the patients was 69.9 ±5.7 years. The mean number of drugs per prescription were 6.33 ± 2.35. Tablets were used in 48.5%, injections in 39.6%, capsules and syrups in 5.5% each and inhalers in 1.1% of patients. Antibiotics were prescribed for 140 patients, diuretics for 34, ACE inhibitors for 33, Calcium channel blockers for 59, H2 blockers for 84, narcotic analgesics and NSAlDs for 36 and 33 patients respectively. Beta blocker usage was minimal. Digoxin, aspirin and thrombolytics were used in 10, 50 and 5 patients respectively. Compliance was 100% and side effects Iike haemoptysis, gastritis, palpitation and vomiting were seen in I patient each.