title: Comparative efficacy and safety of triple therapy (ramipril, telmisartan, hydrochlorothiazide) vs dual anti hypertensive therapy (ramipril or telmisartan, hydrochlorothiazide) in stage 2 hypertensive patients.
abstract: OBJECTIVE
  To evaluate the comparative efficacy and safety of ramipril 5mg plus hydrochlorothiazide 12.5mg (R + HCTZ), telmisartan 40mg plus hydrochlorothiazide12.5mg (T + HCTZ) and ramipril 2.5mg plus telmisartan 20mg plus hydrochlorothiazide12.5mg (R + T + HCTZ) in patients with stage 2 hypertension.
  
  
  METHODS
  A prospective, open label, randomized comparative study was conducted to study the comparative efficacy and safety of R+HCTZ (group 1), T+HCTZ (group 2)and R+T+TCTZ (group3) in 88 patients with stage 2 hypertension without co-morbid conditions. Echocardiography was done to assess left ventricular function. Patients were followed up to 24 weeks and any ADR occurring in this period was recorded.
  
  
  RESULTS
  All the three treatment groups showed significant fall in both systolic and diastolic blood pressure compared to the baseline scores (p<0.0001). Intergroup comparison did not reveal any significant difference. Total number of adverse drug events reported were 15. Group III had higher percentage ADRs. Dry cough (8) was most common ADR. The echocardiography parameters did not change from baseline values with all three treatment regimens.
  
  
  CONCLUSIONS
  All three medications were of equal efficacy in patients with stage 2 hypertension without co morbid conditions, failing to prove superiority over each other.
authors.affiliation: Resident, Department of Pharmacology, Government Medical College , Jammu, India .
authors.forename: Bharat
authors.initials: B
authors.lastname: Bhushan
authors.affiliation: Assistant Professor, Department of Pharmacology, Government Medical College , Jammu, India .
authors.forename: Seema
authors.initials: S
authors.lastname: Gupta
authors.affiliation: Associate Professor, Department of Pharmacology, Government Medical College , Jammu, India .
authors.forename: Vijay
authors.initials: V
authors.lastname: Khajuria
authors.affiliation: Associate Professor, Department of Preventive and Social Medicine, Government Medical College , Jammu, India .
authors.forename: Dinesh
authors.initials: D
authors.lastname: Kumar
authors.affiliation: Professor, Department of Cardiology, Government Medical College , Jammu, India .
authors.forename: Mohan
authors.initials: M
authors.lastname: Lal
authors.affiliation: Assistant Professor, Department of Cardiology, Government Medical College , Jammu, India .
authors.forename: Dharminder
authors.initials: D
authors.lastname: Kumar
authors.affiliation: Lecturer, Department of Cardiology, Government Medical College , Jammu, India .
authors.forename: Sanjeev
authors.initials: S
authors.lastname: Bhat
authors.affiliation: Resident, Department of Pharmacology, Government Medical College , Jammu, India .
authors.forename: Aman
authors.initials: A
authors.lastname: Sharma
keywords: Hydrochlorothiazide; Ramipril; Stage 2 hypertension; Telmisartan; Triple therapy