TO STUDY THE EFFECT OF ANGIOTENSIN RECEPTOR BLOCKERS ON DIABETIC RETINOPATHY
Journal Title: Journal of Evidence Based Medicine and Healthcare - Year 2017, Vol 4, Issue 37
Abstract
BACKGROUND Diabetic Retinopathy (DR) is the most common microvascular complication of Diabetes Mellitus (DM) and is the leading cause of blindness in working age adults of patients with type 1 and 2 DM. Large observational and randomised studies shown that optimal blood glucose and blood pressure control halt or regress the disease and limit the risk of progression to the proliferative stage and visual loss. Recently, evidence has also emerged that Renin-Angiotensin System (RAS) inhibitors may electively prevent or delay progression of retinopathy by acting on local RAS. Thus, metabolic and blood pressure control by RAS inhibition is to prevent or limit the onset of retinopathy and its progression towards visual-threatening stages. The aim of the study is to categorise and analyse grading of DR who are on currently ACE and ARBs unchanged for at least 2 years. MATERIALS AND METHODS 178 patients with type 1 and 2 DM of both genders on ARBs and ACEI unchanged for at least 2 years are divided into two groups as follows- 1. ARB group, which includesa) 28 patients on losartan (50 mg). b) 32 patients on losartan (50 mg) + hydrochlorothiazide (12.5 mg). c) 28 patients on telmisartan (40 mg). d) 32 patients on telmisartan (40 mg) + hydrochlorothiazide (12.5 mg). 2. ACE inhibitor group includesa) 30 patients on enalapril (5 mg). b) 28 patients on ramipril (2.5 mg) + hydrochlorothiazide (12.5 mg). Retinopathy grading assessed by indirect ophthalmoscope and comparison of retinopathy grading between ARBs and ACEI groups have done. Two-tailed Chi-square test, GraphPad Prism Software used for statistical calculations. RESULTS Losartan and telmisartan (ARB group) showed significant protection from diabetic retinopathy than enalapril and ramipril (ACEI group) (p<0.05). CONCLUSION ARBs help in preventing the progression of DR and vision loss in those belonging to mild and moderate nonproliferative diabetic retinopathy patients.
Authors and Affiliations
Chakravarthy K, Anil Choppadandi, Balakrishna Namala, Mohammed Abdul Majeed, Nageswari Devi, Sridhar V. Maddikunta, Madhavi Latha Kodru, Souris Kondaveti
Keywords
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- EP ID EP219086
- DOI 10.18410/jebmh/2017/438
- Views 95
- Downloads 0
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