CLINICAL EFFICACY OF TABS ALURETIC IN THE MANAGEMENT OF MILD TO MODERATE ESSENTIAL HYPERTENSION

Introduction

Tablets Aluretic is an Ayurvedic preparation of ALARSIN (Pharmaceuticals), Bombay.

This drug has proven mild diuretic action.

This study was undertaken to evaluate the clinical efficacy of Tablet Aluretic in the management of mild to moderate essential hypertension.

Material and Methods

60 patients were selected for the study. The diagnosis and grading of hypertension was based on W.H.O. criteria. (Systolic BP of greater than 160 MM. of Hg and or a diastolic BP of greater than 95 mm. of Hg was taken as the Hypertension range and a diastolic BP of 95-110 mm. of Hg was graded as mild hypertension and a diastolic BP of 110-120 mm. of Hg was graded as moderate Hypertension.

All the patients were diagnosed as hypertensives for the first time and only after three successive readings taken on three different occasions showed elevated BP levels.

Routine investigations like blood sugar, urea, serum cholesterol, serum creatinine, serum electrolytes, E.C.G. and chest X-ray were done for all the patients at the point of entry.

The study was conducted in two parts. In part I all the patients were put on tablet Aluretic one tds and BP was recorded once a week for the first four weeks and thereafter once in 15 days. No other drug was administered along with Tablet Aluretic.

Patients were advised salt restriction, weight reduction, and physical exercise.

If there was no adequate response within 21 days from the start of therapy, the patients were put in Part II of the study and the dose of tablets Aluretic was increased to two t.d.s. and BP was recorded once a week for the first four weeks and thereafter once in 15 days.

Results

Of the 60 patients, 34 were males and 26 were females. The average mean age in males was 44.6 years and the average mean age in females was 56.2 years.

24 patients became normotensive in part I of the study (40%), while 28 patients became normotensive in part II of the study (46.67%). 8 patients did not respond adequately to the drug (13.33%).

There was no correlation between the severity of the hypertension and the response to the drug, for out of 8 patients who did not respond to the drug, 5 were mild hypertensives.

One other interesting finding was that the response of the drug was better as age advances for out of 8 patients who did not respond to the drug were young hypertensives of less than 40 years age.

None of the patients developed any biochemical abnormality during the study.

Discussion

Aluretic is a conglomeration of several ayurvedic ingredients and it possesses a mild diuretic action.

Contents of Aluretic

Mechanism of Action

Its mechanism of action, based on experimental studies in Animals is similar to those of thiazide diuretics, in that it inhibits the reabsorption of sodium ions in the proximal convoluted tubules leading to its increased excretion along with water.

The stepped care approach that is being universally followed in the diagnosis, evaluation and treatment of hypertension has clearly established the importance of diuretics in the management of hypertension either as primary agents or secondary to other more potent antihypertensive agents.

Summary

From this study it can be concluded that:

• Aluretic is a mild diuretic.
• It is highly efficacious as a Step I drug in the management of mild to moderate hypertension.
• Its response is better in older individuals.
• It has got a high margin of safety.

References

1. Report of Joint National Committee on Detection, Evaluation and Treatment of High Blood Pressure. A cooperative study JAMA 1977:237, 225-261.
2. Evaluation of Aluretic tablets, an Ayurvedic formulation for diuretic activity in Dogs Dr. A.Y. Nimbakar.
3. The Australian Therapeutic Trial in Mild Hypertension Lancet 1980, 1261-1267.