blood pressure

Both Angiotensin-Converting Enzyme Inhibitors (ACEIs) and Angiotensin Receptor Blockers (ARBs) are recommended first-line agents for hypertension in patients with Type 2 Diabetes Mellitus (T2DM). However, treatment adherence is frequently compromised by class-specific adverse drug reactions (ADRs). This study compares the safety profiles, tolerability, blood pressure control, and short-term renal outcomes of ACEIs versus ARBs in a clinical setting. Methods: A prospective, observational study was conducted over 12 months in a tertiary care teaching hospital. One hundred adult patients ($N=100$) with T2DM and essential hypertension initiating monotherapy with either an ACEI ($n=50$, e.g., enalapril) or an ARB ($n=50$, e.g., losartan) were enrolled. Baseline demographic, clinical, and laboratory safety markers (serum potassium, serum creatinine, and eGFR) were recorded. Safety endpoints included the incidence of dry cough, hyperkalemia, acute kidney injury (eGFR decline greater than 30%), and therapy discontinuation rates. Efficacy was assessed via blood pressure (BP) and urinary albumin excretion rates. Results: Both groups achieved comparable, statistically significant reductions in systolic and diastolic BP, as well as urinary albumin excretion at 12 months ($p > 0.05$ for inter-group comparisons). However, the ARB group demonstrated a significantly superior safety and tolerability profile. Dry cough was reported in 16% of the ACEI group compared to 0% in the ARB group ($p < 0.01$), leading to a therapy discontinuation rate of 10% in the ACEI cohort. Mild hyperkalemia (serum $K^+ > 5.0 \text{ mEq/L}$) occurred in both groups (ACEI: 8% vs. ARB: 6%; $p > 0.05$) without any severe hyperkalemic events or acute kidney injury. Conclusion: While ACEIs and ARBs provide equivalent blood pressure control and renal protection, ARBs offer a significantly superior safety profile with a lower incidence of dry cough and lower treatment discontinuation rates. ARBs may be preferred as a first-line option to optimize long-term treatment adherence in patients with T2DM and hypertension.

Premenstrual syndrome (PMS) is a group of physical, emotional and psychological symptoms experienced by at least 85% of the women in the reproductive age group. The symptoms start a few days after ovulation and continue till menstrual flow occurs after which it ceases. It is a major difficulty experienced by females, given its monthly occurrence. The aim of this study is to determine variations if any in heart rate and blood pressure of females during various stages of menstrual cycle. The study population, consisting of fifty first MBBS students in the age group of 17-20 years, was divided into PMS and non-PMS groups with the help of a symptom tracker that was filled by the candidates over a period of two months. During these two months, the blood pressure and heart rate of each subject was recorded on the 2nd, 12th and 22nd days corresponding to the menstrual, post-menstrual and pre-menstrual phases. Statistical analysis was done for the data obtained using one way ANOVA. It was found that the systolic blood pressure and heart rate showed significant variations in the PMS group. The systolic blood pressure (SBP) was found to be lowest during the menstrual phase (101.9 ± 0.79) which then steeply rose to 117.8 ± 0.99 during the pre-menstrual phase. It was also seen that the menstrual phase SBP of PMS subjects was lower than that of the Non-PMS subjects (111.64 ± 0.96). The heart rate also showed similar variations. From this study, it was concluded that pre-menstrual syndrome can affect systemic parameters such as blood pressure and heart rate.