Efficacy of Monotherapy Versus Combination Therapy in Isolated Systolic Hypertension

Deepa Alex Alexvarghese .


OBJECTIVE: To assess the efficacy of monotherapy and combination drug therapy on Isolated Systolic Hypertension in Elderly. MATERIALS AND METHODS: A cross sectional study was conducted among patients attending the geriatric outpatient department in a tertiary care hospital. The medical records of a total of 530 subjects were screened, out of which 124 individuals were found to have Isolated Systolic Hypertension as per the inclusion criteria. Due to poor drug compliance 24 patients were excluded from the study.100 patients with ISH were categorized on the basis of the antihypertensive drugs they were receiving. The response to therapy was measured in terms of Control of BP. The study was conducted over a period of 6 months. A detailed history was obtained from all patients including their complaints, co-morbid illnesses, medications and personal history. The blood pressure response to various drugs was analysed. RESULTS In the total study population of 100 patients 32 patients were on monotherapy and 68 patients were on a combination of antihypertensive drugs. Among patients receiving monotherapy, 56.25percent were on Calcium channel blockers, 31.25percent on ACE inhibitors and 12.5percent on Beta blockers. BP control was comparatively higher among those on calcium channel blockers. In subjects on a combination of antihypertensives, 54percent were on ACE inhibitors and Calcium Channel Blockers and 46 percent on ACE inhibitors, Calcium channel blockers and Beta blockers. The former group was found to be more effective in BP control. CONCLUSION In patients receiving monotherapy, Calcium channel blockers were found to have better efficacy when compared to other drug groups. In combination therapy, patients on ACE inhibitors and Calcium channel blockers were found to be more effective.

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