European Journal of Cardiovascular Medicine

Introduction: Hypertension is a condition in which the blood flows through the blood vessels with a force greater than normal. Patient with hypertension have an increased prevalence of type 2 diabetes mellitus (T2DM) and impaired glucose tolerance, and the prevalence of type 2 diabetes is increasing in epidemic proportions worldwide. Several trials involving patients with hypertension or cardiovascular disease have suggested that agents that block or inhibit the renin angiotensin system that is ACE inhibitors and ARBs decrease the incidence of new-onset type 2 diabetes. However, the exact role of these agents in diabetes prevention has not yet been fully elucidated. Blocking angiotensin II decreases proinflammatory mediators and the oxidative stress.  Material and Methods: This is a prospective and observational was conducted in the outpatient Department (OPD) of General Medicine and Department of Pharmacology at Shadan Institute of Medical Sciences, Teaching Hospital & Research Centre -A Post Graduate Institute (SIMS), Hyderabad from April 2018 to March 2019. In 100 prediabetic hypertensive outpatients, 78 prediabetic hypertensive outpatients [45 males, 33 females mean age = 49.85±10.35] continued for a period of 12 months. The patients were recruited with following inclusion and exclusion criteria. Fasting blood sugar test: a blood sugar level from 100 to 125mg/dL (5.6 to 6.9mmol/L) is considered as Pre-diabetes, this is sometime referred to as impaired fasting glucose (IFG). Results: In our study 78 cohorts of hypertensive Prediabetic patients on ACE /ARBs were followed for one year and at the end of the study when all the parameters were compared at first visit /baseline with that of third visit /at the end of 12 months in both of the ARB (Telmisartan) and ACEI (Ramipril) group, it was observed that there is decrease in the mean and standard deviation of the different parameters included in the study i.e., SBP(mm Hg), DBP(mm Hg), FBG(mg/dl), OGGT(mg/dl) and HbA1c(%).In Telmisartan and Ramipril groups on the final visit at the end of 12 months, compared to the first visit or at base line, there is no significant difference in the p values of the different parameters i.e., SBP(mm Hg), DBP(mm Hg), FBG(mg/dl), OGGT(mg/dl) and HbA1c. Conclusion:  In the present study it was observed that in hypertensive pre-diabetes patients, the beneficial effect of RAAS Inhibitors is more marked if the therapy started with initial rise diastolic and systolic blood pressure, especially at a relatively younger age.