Effectivity Evaluation of Bisoprolol as Additional Hypertension Therapy in Geriatrics with Type 2 Diabetes Mellitus while ongoing with Dual Oral Anti-Hypertension Agent. A Cohort Study

Background: Bisoprolol is a beta-blocker agent that is widely used as an antihypertensive agent, cardiac rate control, and agent to improve the cardiac ejection fraction. Bisoprolol is commonly added to hypertension therapy in patients with a high risk of heart disease such as hypertension with diabetes. The effectiveness of beta-blocker agents in the treatment of hypertension in geriatrics with diabetes without a history of CVD who are currently using dual therapy is still minimal. Evaluation of this matter needs to be done to complement scientific evidence in the use of bisoprolol in the treatment of hypertension in geriatrics with type 2 diabetes mellitus. Objective: This study aims to compare the effectiveness of bisoprolol as additional therapy in geriatric patients who have diabetes hypertension without CVD history while they are ongoing dual oral antihypertension therapy. Method: A cohort study involving 82 geriatrics was prospectively observed for four weeks. The exposure in this study was the bisoprolol agent. Subjects were divided into two groups, where all patients would undergo dual antihypertensive agents, namely Angiotensin-Receptor-Blocker (ARB) and Calcium-Channel-Blocker (CCB). Reductions in systolic and diastolic blood pressure were observed as primary outcomes, and success in achieving blood pressure goals was observed as a secondary outcome in the study. Result: There was no difference in the decrease in systolic and diastolic blood pressure in the exposure and non-exposure groups (p> 0.05). Judging from the large number of patients who successfully achieved the therapeutic target also showed no significant difference between the exposure and non-exposure groups with systolic and diastolic risk difference (RD) values of 1,091 (CI95%: 0.545-2.184) and 1,222 (CI95%: 0.781-1.913). Conclusion: The addition of bisoprolol agents in geriatric patients with hypertension and diabetes without a history of CVD is not required. KEYWORDS: Bisoprolol, Oral Antihypertensive, Type 2 Diabetes Mellitus, Geriatrics, Combination Therapy