Dose titration of concurrent use of two antihypertensives in a teritary care superspeciality hospital

Ramipril is an angiotensin converting enzyme (ACE) inhibitor and Metoprolol a β-adrenergic blocker used as antihypertensive. In this study we aimed to titrate the concurrent use of two most conventionally used antihypertensives. Objectives of this study were to evaluate the effect of regular intake of Ramipril and Metoprolol by patients with mild to moderate grade of hypertension, to adjust the dose and to educate the patients by providing patient counseling. In this multidose open label randomized block study, was conducted between March 2010 and November 2010 at CARE super specialty hospital, Hyderabad. A total of 60 patients were enrolled and were asked to have total of four visits including first screening visit, with 6 weeks interval between each visit. Study treatments included; Dose A (2.5mg Ramipril+25mg Metoprolol), Dose B (5mg Ramipril+50mg Metoprolol) and Dose C (10mg Ramipril+50mg Metoprolol) and patient counseling emphasizing on the role of diet, life style modification and regular exercise for management of hypertension. Blood pressure (B.P) was measured on every visit including the day of enrolment and the results were analyses from the data obtained. The study concluded that gradual up-gradation of the combination dose was useful in controlling hypertension. Along with it, patient counseling was found to be beneficial for the patients.