Comparison of effects of benidipine and amlodipine on clinical and biochemical parameters in hypertensive patients: an observational study

Background: Hypertension is a widespread public health problem and a major risk factor for cardiovascular disease. Amlodipine, a calcium channel blocker, dilates arterioles by blocking L-type calcium channels. Benidipine inhibits L, N, and T type calcium channels. We compared the efficacy of Amlodipine and benidipine on blood pressure, pulse rate, proteinuria and lipid profile in hypertensive patients.Methods: The study was an observational, prospective, open label comparison. Eligible hypertensives were given either amlodipine (5mg/d) or benidipine (4mg/d). Clinical features and laboratory parameters were recorded initially and after 3 months. Adverse events were recorded with the help of a questionnaire. Compliance was assessed by return pill count.Results: Out of 35 patients, recruited for study, 16 received amlodipine and 17 were treated with benidipine and two were lost during follow up. Both the groups were well matched in terms of age, body weight, clinical findings and laboratory values. Both the drugs significantly (P <0.05) reduced systolic (142±16 to 138±15 vs.148±16 to 134±14mmHg) and diastolic blood pressure (81±9 to 79±7). In the Amlodipine group the pulse rate after treatment tended to be higher than before (70±9 to 72±10bpm). In the Benidipine group there was decrease in pulse-rate after treatment (69±9 to 67±9). Unlike Amlodipine, Benidipine significantly (P<0.05) decreased urinary protein excretion (1.0±1.2 to 1.1±1.4 vs. 1.4±2.5 to 1.1±1.7g/g-Cr) and serum triglycerides (125±25 to 120±23 vs 130±26 to 115±21mg/dl).Conclusions: In this study, amlodipine and benidipine were found to be be equally effective anti-hypertensive in patients with stage 1 hypertension. However, there was significant reduction in proteinuria and serum triglycerides in Benidipine group as compared to Amlodipine group. Benidipine may be a better alternative to existing calcium channel blockers

A comparative study of antihyperglycemic effect of Gymnema sylvestre and metformin in streptozotocin induced diabetic rats

Background: Diabetes mellitus (DM) is a metabolic disorder that has the phenotype of hyperglycemia. According to World Health Organization (WHO) there were 65.1 million diabetics in India in 2013, International Diabetes Federation estimates this to increase to 190 million by 2035. Although a number of drugs are available for treatment of DM, their cost and safety profile are major concern. Medicinal plants are used by clinicians for treatment of diabetes. Gymnema sylvestre (GS) extract has been reported to increase insulin levels in diabetic rats. This study was designed to compare the antihyperglycemic effect of Gymnema sylvestre with metformin.Methods: Diabetes was induced in Sprague-Dawley rats using streptozotocin 45mg/kg. Methanolic extract of Gymnema sylvestre 120mg/kg p.o. prepared using Soxhlet apparatus.Results: GS extract reduced blood glucose levels but not statistically significant. GS extract increased HDL and triglycerides, reduced both serum ALT and AST but no statistical significance seen. Metformin significantly increased serum urea, which was not seen in GS extract group. GS extract showed regenerative changes in pancreas, liver and kidney.Conclusions: The study investigation demonstrates that methanolic extract of GS possesses antihyperglycemic and hypolipidaemic activity and so it can be considered as a promising natural remedy in a prediabetic state and in mild hyperlipidaemia to prevent its progression. Increase in β cell regeneration activity could be a probable mechanism of action. However, further long term clinical studies are recommended to define its possible role in diabetes mellitus and hyperlipidaemia. Role of GS as a potential hepatoprotective agent also needs further evaluation