Comparative Study on the Efficacy of Different Antihypertensive Classes in Early-Stage Hypertension with Renal...

Hypertension remains a leading cause of cardiovascular and renal morbidity worldwide. In early-stage hypertension, appropriate pharmacological intervention is crucial to prevent target organ damage, especially renal impairment.

A randomized, controlled, open-label study was conducted over 12 weeks at a tertiary care hospital. A total of 120 patients newly diagnosed with Stage 1 hypertension (SBP 140-159 mmHg or DBP 90-99 mmHg) were enrolled and equally divided into three groups: Group A (ACE inhibitors), Group B (CCBs), and Group C (beta-blockers). Baseline and post-treatment parameters including systolic and diastolic BP, serum creatinine, and estimated glomerular filtration rate (eGFR) were recorded. Data were analyzed using ANOVA and paired t-tests.

The SBP was reduced by the largest percentage in group A (ACE inhibitors; mean decrease of 16.4+/- 3.2 mmHg) as well as in group C (CG intervention; mean decrease 16.2+/- 2.2 mmHg), and the eGFR increased by the largest percentage in group A (ACE inhibitors; mean increase of 5.6+/- 1.8 mL/min/1.73 m 2). Group B (CCBs) had modest reduction in BP (mean SBP lowering of 13.7 + 2.9 mmHg) and little effect on the renal functionality. The beta-blockers (group C) achieved the lowest amount of reduction in SBP (11.2 + 3.1 mmHg) and minimal change in eGFR at mean reduction of 1.4 + 2.1 mL/minute/1.73 m 2.

ACE inhibitors are more effective in controlling early-stage hypertension and provide additional renal protective benefits compared to CCBs and beta-blockers. These findings support the preferential use of ACE inhibitors in hypertensive patients with early signs of renal function compromise.