COMORBIDITY-SPECIFIC HEMODYNAMIC RESPONSE TO LOSARTAN AND TELMISARTAN IN PRIMARY HYPERTENSIVE PATIENTS: A DESCRIPTIVE SUBGROUP ANALYSIS

Abstract

Primary hypertension often coexists with comorbidities such diabetes mellitus, dyslipidemia, atherosclerosis, and coronary artery disease, each of which can independently affect vascular function and hemodynamic metrics. Angiotensin receptor antagonists (ARBs), such as losartan and telmisartan, are frequently utilized antihypertensive medications that have proven efficacy in regulating blood pressure and arterial hemodynamics. Objective: To thoroughly assess the comorbidity-specific changes in systolic blood pressure (SBP), diastolic blood pressure (DBP), pulse pressure (PP), mean arterial pressure (MAP), and ankle-brachial index (ABI) after a four-week regimen of losartan or telmisartan in patients with particular cardiovascular and metabolic comorbidities. Methods: This secondary, descriptive subgroup analysis included anonymized patient-level data from a prospective, non-interventional observational study carried out at the Department of Cardiology, Geetanjali Medical College & Hospital, Udaipur. The parental group comprised 210 individuals aged 18 to 65 years diagnosed with primary hypertension who were administered ACE inhibitors or ARBs across a six-month enrollment timeframe. In the current examination, individuals administered losartan 50 mg or telmisartan 40 mg were classified based on the existence of diabetes mellitus, dyslipidemia, atherosclerosis, or coronary artery disease. Only subgroups with a minimum of five patients were included. SBP, DBP, PP, MAP, and ABI were evaluated at the outset and following a four-week therapy period. Due to the limited sizes of the subgroups, descriptive statistics were employed, and no inferential statistical analyzes were conducted. Results: Within the qualifying comorbidity-specific cohorts, alterations in SBP, DBP, PP, and MAP were predominantly minimal after four weeks of intervention. ABI results persisted within a somewhat limited spectrum, with only slight fluctuations between initial and subsequent assessments. The results indicated that the hemodynamic reaction to losartan and telmisartan varied among different comorbidity categories; still, the limited patient numbers in each category restricted formal statistical analysis. Conclusion: This detailed subgroup analysis yields initial, hypothesis-forming insights on comorbidity-specific hemodynamic reactions to losartan and telmisartan. The results advocate for more research employing bigger, sufficiently powered groups to ascertain if particular comorbidities correlate with significant variations in the vascular and blood pressure impacts of individual ARBs.