BEAT Survey: A Cross-sectional Study of Resting Heart Rate in Young (18-55 Year) Hypertensive Patients.

BACKGROUND: Studies in Caucasian population have shown that sustained elevation of heart rate (HR) is associated with increased cardiovascular mortality and morbidity in patients with heart failure (HF), myocardial infarction (MI). However, resting HR is not so well-studied in Indian hypertensive patients. MATERIALS AND METHODS: BEAT is a cross-sectional survey to evaluate the resting HR in young (18-55 years) patients in India. Also study aims to correlate it with age, BP and body mass index (BMI) along with smoking habit and past medical history like coronary artery disease. RESULTS: A total of 3743 patients (mean age 45.69 ± 6.86 years; males 66.52%) were enrolled in study. Of them, 886 (23.67%) were diabetic, 712 (19.02%) had history of coronary artery disease and 818 (21.85%) had history of ever smoking.The average BMI was 26.15 (3.92) with majority of patients falling in either obese (19.85%) or overweight (53.42%) category. The average resting HR and BP were 82.79 ± 10.41 bpm and 146.82 ± 15.46/ 89.08 ± 8.8 mmHg. HR was found to have correlation with SBP (r = 0.247, p < 0.01), DBP (r = 0.219, p < 0.01); to lower extent with BMI (r = 0.041, p < 0.05); but not with age (r = -0.012, NS). CONCLUSION: The resting HR is elevated in the Indian hypertensive patients. It was found to have correlation with BP and to lesser extent with BMI, whereas there was no correlation with age. The chronically elevated HR even in patients under treatment may have implication on cardiovascular mortality and morbidity.

Correlation between peripheral arterial disease and coronary artery disease using ankle brachial index-a study in Indian population.

OBJECTIVE: To study the prevalence of peripheral arterial disease (PAD) of the lower limbs in a high-risk population and its correlation with coronary artery disease (CAD), using the ankle brachial index (ABI). METHODS: The present study was conducted in randomly selected indoor patients >45 years of age with one or more risk factors for PAD admitted in the cardiology and medicine wards in a tertiary care institute. RESULTS: Based on ABI <0.9, PAD was diagnosed in 32 of the 182 (18%) patients. Coronary artery disease was present in 15 cases of PAD which was statistically significant. CONCLUSION: There is a definite and strong correlation between PAD and CAD. Correct diagnosis and supervision of patients with PAD is important for preventing the local progression of the disease and effective secondary prevention of future coronary and cerebrovascular events.

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.