Comparative Studies of Efficacy and Effects on Oxidative Stress of Amlodipine and Ramipril in the Hypertensive Patients of North East India

Objective: To compare the efficacy and the effect of the oxidative stress of Calcium Channel Blocker (CCB), Amlodipine and Angiotensin Converting Enzyme (ACE) inhibitor, Ramipril in the hypertensive patients of North East India. Methods: It is a prospective randomized controlled parallel study of the clinically used antihypertensive drug. Total 75 subjects were included in the study. Out of 75 subjects, 25 numbers were normal healthy subjects and remaining 50 were hypertensive patients. The patients were randomized and divided into two groups; Amlodipine treated group (n=25) and Ramipril treated group (n=25). Amlodipine group received Amlodipine (5-10) mg/day and Ramipril group received Ramipril daily (5-10) mg. All patients were newly detected hypertensive subjects suffering from essential hypertension without any prior antihypertensive therapy. Patients included were either sex (male/female) in age group of 20-65 y with normal fasting blood sugar level (FBS) and free from any other diseases. All groups was subjected to measurement of blood pressure, estimation of blood parameters like FBS, serum lipid profiles, serum glutamate pyruvate transaminase (SGPT) and serum glutamate oxaloacetate (SGOT) before antihypertensive treatment. The height, age, weight, health status and lifestyle pattern of patients were recorded. The patients were followed up during 8 w of antihypertensive treatment. Serum levels of glutathione (GSH), total antioxidant (TAS), superoxide dismutase (SOD) and malondialdehyde (MDA) levels were estimated before and after 8 w of antihypertensive therapy. Results: The present study indicated that both amlodipine and ramipril have significant effects on normalizing systolic and diastolic blood pressure (BP) after 8 w of treatment. Ramipril significantly reduced malondialdehyde (MDA) level and increased the serum levels of GSH, TAS and SOD during antihypertensive treatment. Ramipril reduces oxidative stress because of its antioxidant activity during antihypertensive therapy. Conclusion: Amlodipine and Ramipril are effective antihypertensive drugs. ACE inhibitor (Ramipril) has additional benefit of reducing oxidative stress thereby restoring the endothelial dysfunction in the hypertensive patient.