Comparative Study to Evaluate Efficacy, Safety and Quality of Life of Metoprolol and Telmisartan versus Metoprolol and Ramipril in Patients of Hypertension


Sonia Arora
Vijay K. Sehgal
Jasbir Singh
Harcharan Singh


Background: Hypertension(HTN) is a major cardiovascular disease and is a major worldwide clinical problem. The prevalence of hypertension increases in urban and rural areas. The treatment of hypertension began in the 1960s with oral diuretics. The other modalities of treatment of hypertension are beta – blockers, calcium-channel blockers, alphareceptors blockers, ACE inhibitors and ARBs. The better compliance occurs with single-pill combination, and may be even double or even triple pill combination therapy should be used. Also quality of life was improved better with Metoprolol and Telmisartan as compared with Metoprolol and Ramipril. Quality of life was assessed by SF -36 Quiestionnare. Objective: To compare the effect of Metoprolol and Telmisartan versus Metoprolol and Ramipril on BP and quality of life in patients of hypertension. Material and Methods: In this prospective, open, randomized, parallel group, comparative study, 80 patients of hypertension attending the Cardiology Outpatient Department, Govt. Medical College & Rajindra Hospital, Patiala were recruited. This randomized comparative study was done on 80 patients for 4 months. Quality of Life: In my project of Quality of life, I had taken total 80 patients and the patients were divided into two groups and 40 patients each of Metoprolol and Ramipril versus Metoprolol and Telmisartan. To assess quality of life questionnaire SF-36 was administered to the patients. Results: There was a marked decrease in SBP and DBP with the use of Metoprolol and Telmisartan than Metoprolol and Ramipril. There was also no change in demographic parameters. There was significant improvement in the quality of life with Metoprolol and Telmisartan. Conclusion: Metoprolol and Telmisartan was a better choice than Metoprolol and Ramipril in treating hypertension as this combination causes more reduction in BP and little effect on HR.


How to Cite
Arora, S., Sehgal, V. K., Singh, J., & Singh, H. (2019). Comparative Study to Evaluate Efficacy, Safety and Quality of Life of Metoprolol and Telmisartan versus Metoprolol and Ramipril in Patients of Hypertension. International Journal of Medical and Dental Sciences, 1728–1738.


  1. Benndorf RA, et al. Pleiotropic effects of telmisartan: Still more to come? J Hypertension. 2008; 26(5):854–6. https:// PMid:18398324
  2. Stafylas PC, Sarafidis PA. Carvedilol in hypertension treatment. Vasc Health Risk Manag. 2008 Feb; 4(1):23–30. PMid:18629377 PMCid:PMC2464772
  3. Chobanian AV, Bakris GL, Black HR, Cushman WC, Green LA, Izzo JL, et al. Seventh Report of the joint national committee on prevention, detection, evaluation, and treatment of high blood pressure: The JNC report. JAMA. 2003; 289(19):2560–72. jama.289.19.2560 PMid:12748199
  4. Gupta R. Trends in hypertension epidemiology in India. J Hum Hypertens. 2004 Feb; 18(2):73–8. PMid:14730320
  5. Chrysant SG, Chyrysant GS, Dimas B. Current and future status of beta- blockers in the treatment of hypertension. Clinical Cardiology. 2008 Jun; 31(6):249–52. PMid:18543303
  6. Saseen JJ, MacLaughlin. Hypetension. DiPiro JT, Talbert RL, Yee GC, Matzke GR, Wells BG, Posey LM, editors. Pharmacotherapy: A pathophysiologic approach. 9th ed. New York: McGraw-Hill Medical; 2014.
  7. CDC: High blood pressure. Centers for Disease Control and Prevention; 2015. Available from: bloodpressure/index.htm
  8. James PA, Oparil S, Carter BL, Cushman WC, DennisonHimmelfarb C, Handler K, Lackland DT, LeFevre M, MacKenzie TD, Ogedegbe O, Smith SC, Svetkey LP, Taler SJ, Townsend RR, Wright J, Narva AS, Ortiz E. Evidence based guideline for the management of high blood pressure in adults: report from the panel members appointed to the Eighth Joint National Committee (JNC 8). JAMA. 2014; 311(5):507–20. Available from: PMid:24352797
  9. Friedrich MG, Dahlof B, Sechtem U, Unger T, Knecht M. Telmisartan Effectiveness on Left Ventricular Mass Reduction (TELMAR) as assessed by mabnetic resonance imaging in patients with mild-to-moderate
  10. hypertension- a prospective, randomized, double- blind comparison of telmisartan with metoprolol over a period of six months- rationale and study design. Journal of the Renin-Angiotensin-Aldosterone System. 2003 Dec; 4(4):234–43. PMid:14689371
  11. Ong HT, FRCP, Rozina G, FRCP. Selecting antihypertensive medication in patients with essential hypertension in Malaysia. Med J Malaysia. 2009; 64(1):2009 Mar.
  12. Tomiyama H, Yamashina A. Beta- blockers in the management of hypertension and/or chronic kidney disease. International Journal of Hypertension. 2014; 1–7. PMid:24672712 PMCid:PMC3941231
  13. Matchar DB, McCrory DC, Orlando LA, Patel MR, Patel UD, Patwardhan MB, et al. Systematic review: Comparative effectiveness of angiotensin- converting enzyme inhibitors and angiotensin II receptor blockers for treating essential hypertension. Ann Intern Med. 2008; 148:16–29. https:// PMid:17984484
  14. Agarwal A, Chhabra MK, Walia R, Gupta PD. Comparative evaluation of Metoprolol and Telmisartan in hypertensive patients. 2014 Jul; 3(2): 403–10. Available from:
  15. Kumar P, Kapoor AK, Singh HK, Kulshrestha M, Randomized. Interventional, prospective, comparative study to evaluate the antihypertensive efficacy and tolerability of Ramipril versus Telmisartan in stage 1 hypertensive patients with diabetes mellitus. Internet Journal of Medical Update. 2015 Jan; 10(1):15–25.
  16. Zou Z, Xi G–L, Yuan HB, Zhu Q-F, Shi X-Y. Telmisartan versus Angiotensin converting enzyme inhibitors in the treatment of hypertension: a meta-analysis of randomized controlled trials. Journals of Human Hypertension. 2008; 23(5):1-11.
  17. Soni RK, Porter AC, Lash JP, Unruh ML. Health-related quality of life in hypertension, chronic kidney disease and coexistent chronic health conditions. Adv Chronic Kidney Dis. 2010 Jul; 17(4):e17–26. PMid:20610351 PMCid:PMC2901238
  18. Shanableh S, Abdulkarem A, Shamssain M, Sarhan F. Quality of life of hypertensive patients on different types of antihypertensive medications. IOSR Journal of Pharmacy. 2014 May; 4(5):23–8.

Most read articles by the same author(s)

1 2 > >>