IS DOSE TITRATION REQUIRED FOR ANTIHYPERTENSIVE AGENTS IN GERIATRIC DIABETIC PATIENTS?
Journal Title: Asian Journal of Pharamceutical and Clinical Research - Year 2018, Vol 11, Issue 12
Abstract
Objective: The objective of this study is to evaluate the antihypertensive drug usage and dosage differences between geriatric and non-geriatric diabetics with reference to the duration of hypertension and creatinine clearance (Crcl).Methods: In this observational study, patients with type 2 diabetes mellitus were grouped into geriatric (age ≥60 years) and non-geriatric (age <60 years). Patients’ demographic data, duration of hypertension, drugs prescribed, and serum creatinine were recorded after the patients had a stabilized antihypertensive dose for 6 months. Crcl was calculated using Cockcroft–Gault formula. The dosages of antihypertensives were converted into equivalent doses for easy comparison within a group. For angiotensin-converting enzyme inhibitors (ACEIs), enalapril was considered as prototype, and for angiotensin receptor blockers (ARBs) losartan, beta-blocker atenolol, and calcium channel blockers (CCBs), amlodipine was considered as prototype. Univariate analysis was done for comparison of drug doses between groups.Results: A total of 336 diabetics with hypertension were included, of which 252 were geriatric and 84 non-geriatric. Duration of hypertension was expectedly longer in the geriatric group (8.40±7.26 vs. 5.46±5.67; p=0.001). Systolic blood pressure was higher in geriatrics (137.14±13.51 vs. 133.38±12.49; p=0.01). When adjusted for the duration of hypertension and Crcl, there were no significant differences in the mean converted equivalent doses of beta-blockers, CCBs, ARBs, and hydrochlorothiazide between geriatrics and non-geriatrics. However, statistically significant lower converted equivalent doses of all ACEIs were needed in geriatrics compared to non-geriatrics, when adjusted for duration of hypertension and Crcl. Enalapril required 20.57% and ramipril required 18.36% dose reduction in geriatrics compared to non-geriatrics.Conclusion: A 20% dosage reduction is needed for ACEIs in the elderly.
Authors and Affiliations
Rajeshwari Shastry, Prabha M R Adhikari, Sheetal D Ullal, Mukta N. Chowta, Sahana D Acharya
Keywords
Related Articles
- EP ID EP605261
- DOI 10.22159/ajpcr.2018.v11i12.29181
- Views 124
- Downloads 0
COMPARATIVE ESTIMATION OF SALIVARY TOTAL ANTIOXIDANT CAPACITY IN PERIODONTAL HEALTH AND CHRONIC PERIODONTITIS - A PILOT STUDY
Objective: Gram-negative bacteria provoke polymorphonuclear leukocyte (PMN) to release reactive oxygen species in chronic periodontitis (CP). Inability to maintain a balance between oxidative stress and antioxidant level...
THE THE INFLUENCE OF THE EXCIPIENTS ON THE ANTI-INFLAMMATORY EMULGEL BIOPHARMACEUTICAL QUALITY PARAMETERS
Objective: Boswellia serrata dry extract (BSDE) has clinically proved its anti-inflammatory, anti-gout, and analgesic effect. In the course of this study, compositions and technologies of the emulgels, containing dry Bos...
RP-HPLC METHOD DEVELOPMENT AND VALIDATION FOR THE SIMULTANEOUS ESTIMATION OF ATORVASTATIN AND EZETIMIBE IN PHARMACEUTICAL DOSAGE FORM
 Objective: The aim was to develop a simple, selective, linear, precise, and accurate reverse phase high performance liquid chromatography methodfor simultaneous estimation of atorvastatin and ezetimibe in tablet dosage...
SALIVARY PROTEIN AND GLUCOSE LEVELS IN DIABETIC AND NON-DIABETIC PATIENTS - A REVIEW
Saliva is the most important tool to monitor various biochemical parameters including protein and glucose. Hence, it can be used as a tool to find if a patient is diabetic or nondiabetic. This review presents information...
ONE-POT SYNTHESIS OF 2,4,5-TRIARYLIMIDAZOLES FROM KETO-OXIMES: CHARACTERIZATION AND EVALUATION OF ANTIMICROBIAL ACTIVITY
Background and Objective: Imidazole scaffold is pervasive in pharmaceuticals and it possesses diverse type of biological activities, especially triarylimidazole derivatives are biologically prominent molecules which insp...