Effectiveness and metabolic effects of perindopril and diuretics combination in primary hypertension

Elisaf, Moses; Theodorou, J; Pappas, Haralambos; Papagalanis, Nicolas; Katopodis, Konstantinos P.; Kalaitzidis, Rigas; Siamopoulos, Kostas C.

doi:10.1038/sj.jhh.1000834

Cited by 14 publications

(5 citation statements)

References 22 publications

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“…These metabolic effects are commonly seen with diuretic therapy and may be ameliorated by the combination with ACE inhibitor therapy. 41 The decrease in creatinine clearance seen in both groups is in keeping with that seen with most antihypertensive therapy and particularly with RAS inhibitors.…”

Section: Discussionsupporting

confidence: 59%

Effect of Low-Dose Perindopril/Indapamide on Albuminuria in Diabetes

et al. 2003

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Abstract-Microalbuminuria in diabetes is a risk factor for early death and an indicator for aggressive blood pressure (BP) lowering. We compared a combination of 2 mg perindopril/0.625 mg indapamide with enalapril monotherapy on albumin excretion rate (AER) in patients with type 2 diabetes, albuminuria, and hypertension in a 12-month, randomized, double-blind, parallel-group international multicenter study. Four hundred eighty-one patients with type 2 diabetes and hypertension (systolic BP Ն140 mm Hg, Ͻ180 mm Hg, diastolic BP Ͻ110 mm Hg) were randomly assigned (age 59Ϯ9 years, 77% previously treated for hypertension). Results from 457 patients (intention-to-treat analysis) were available. After a 4-week placebo period, patients with albuminuria Ͼ20 and Ͻ500 g/min were randomly assigned to a combination of 2 mg perindopril/0.625 mg indapamide or to 10 mg daily enalapril. After week 12, doses were adjusted on the basis of BP to a maximum of 8 mg perindopril/2.5 mg indapamide or 40 mg enalapril.

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Section: Discussionsupporting

confidence: 59%

Effect of Low-Dose Perindopril/Indapamide on Albuminuria in Diabetes

et al. 2003

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“…Perindopril, in addition to the blood pressure reduction, also showed a slight increase in serum K+ (data not shown) with a decrease in urNa + excretion and an improvement in the glycosylated hemoglobin. This is in accordance with previous data, showing that perindopril can induce a slight serum K+ increase and, although not significantly, a slight improvement on serum glucose and insulin sensitivity [46].…”

Section: Discussionsupporting

confidence: 93%

Different Effects of Canagliflozin and Perindopril in the Improvement of Arterial Stiffness in Type 2 Diabetic Patients

2021

CRDOJ

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Introduction: In type 2 diabetic patients (DM), after 6 months under perindopril or Canagliflozin, we previously reported a significant cf-PWV improvement related to high serum uric acid (SUA), stronger than the observed with blood pressure.Aims: To evaluate, in DM patients with arterial hypertension and normal renal function, the effects of canagliflozin or perindopril on SUA, 24hs ambulatory BP monitoring (ABPM) and cf -PWV.Methods: For 6 months, 20patients with DM and hypertension (59±4y; 10 females) received Metformin 2000mg, Amlodipine 10mg and Canagliflozin 300mg daily. Other 20 type 2 diabetic patients (62±4y, 8 female) received Metformin 2000mg, Amlodipine 10mg and Perindopril10mg daily. Parameters evaluated: HbA1C, fasting blood glucose level, glomerular filtration rate, SUA, urine uric acid excretion (urUA), 24h ABPM and cf-PWV. All evaluations were determined at baseline and after a 6-month continued treatment.Results: After 6 months treatment, Canagliflozin induced a decrease in cf-PWV (12.0±0.67 to 8.5±0.45m/sec, p<0.001), HbA1C (8.5±0.11 to 7.0±0.09%, p<0.001), SUA (7.9±0.22 to 6.9±0.45mg%, p<0.05) and ABPM (142.0±2.04/99.0±1.34 to 134.0±2.01/85.0±1.57mmHg, p<0.001). Perindopril only reduced ABPM (140.0±2.10/95.0 to 133.0±1.57/84.0±1.79mmHg, p<0.001) and cf-PWV (11.6±0.89 to 8.0±0.45m/sec, p<0.05). Only under Canagliflozin the urUA increased (350.0±4.47 to 580.0±6.71mg/24hs, p<0.001). A strong correlation was found between variations in SUA and cf-PWV(r: 0.69, p<0.025),showing that for each 1mg% reduction in SUA there is a decrease of 0.88m/sec in PWV.Conclusions: Canagliflozin and Perindopril ameliorates arterial stiffness in patients with type 2 DM and hypertension by reducing SUA that seems related, among other mechanisms, with a vascular intrinsic effect.

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“…Regarding other ACE inhibitors, perindopril [56,57], trandolapril [58] and quinapril [59] appear to have a "neutral" effect on SUA levels. Lisinopril may have no effect or only cause a slight decrease in SUA levels [60,61].…”

Section: Enalapril and Captopril And Other Ace Inhibitorsmentioning

confidence: 99%

Effect on Serum Uric Acid Levels of Drugs Prescribed for Indications other than Treating Hyperuricaemia

Daskalopoulou

Tzovaras²,

Mikhailidis³

et al. 2005

CPD

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Beyond allopurinol and the well-established uricosuric drugs, several other agents can decrease serum uric acid (SUA) levels, such as losartan, fenofibrate and some non-steroidal anti-inflammatory drugs (NSAIDs). Some of these drugs increase renal urate excretion. Hyperuricaemia and gout are common problems (at least 1% of Western men are affected by gout). Raised SUA levels increase the incidence of acute gout and renal calculi. Hyperuricaemia may also predict an increased risk of vascular events. Therefore, lowering SUA levels is of clinical relevance. In this review we consider the effect on SUA levels of drugs that are prescribed for indications other than treating hyperuricaemia. These drugs may obviate the need for specific treatment (e.g. allopurinol) aimed at lowering SUA levels. Furthermore, because hyperuricaemic patients may already be on several drugs (e.g. due to associated dyslipidaemia, hypertension and/or arthritis) compliance may be improved by avoiding additional medication. The potential for adverse effects associated with polypharmacy would also be decreased.

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Effectiveness and metabolic effects of perindopril and diuretics combination in primary hypertension

Cited by 14 publications

References 22 publications

Effect of Low-Dose Perindopril/Indapamide on Albuminuria in Diabetes

Effect of Low-Dose Perindopril/Indapamide on Albuminuria in Diabetes

Different Effects of Canagliflozin and Perindopril in the Improvement of Arterial Stiffness in Type 2 Diabetic Patients

Effect on Serum Uric Acid Levels of Drugs Prescribed for Indications other than Treating Hyperuricaemia

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