Efficacy of indapamide 1.5 mg, sustained release, in the lowering of systolic blood pressure

Abstract

The relationship between the increase in blood pressure and the incidence of cardiovascular disease is well recognized today. Studies have shown that more attention should be paid to systolic blood pressure (SBP) in relation to cardiovascular risk and that therapeutic interventions should preferably focus on reducing SBP. The antihypertensive efficacy of indapamide 1.5 mg sustained release (indapamide SR), a lowdose thiazide-type diuretic, was assessed on SBP. Three randomized, double-blind, controlled studies were conducted with indapamide SR, over a period of 3 to 12 months. Elderly patients or patients with target-organ damage, hypertension and left ventricular hypertrophy (LVH) (LIVE study) or with type II diabetes with microalbuminuria (NESTOR study) showed a decrease in SBP varying from 22.7 to 31.8 mmHg. The treatment with indapamide SR resulted in a better or equivalent control of SBP than treatment with a standard dose of a true thiazide diuretic (hydrochlorothiazide), a calcium channel blocker (amlodipine), and an angiotensin-converting enzyme inhibitor (enalapril). No therapeutic escape was observed. All treatments showed good acceptability with no unexpected adverse event. In conclusion, indapamide SR is very effective in lowering SBP-a major independent cardiovascular risk factor-notably in hypertensive high-risk patients with LVH, the elderly and diabetics, when compared to major antihypertensive treatments. This SBP-lowering effect is maintained over the long term.

A Meta-Analytical Approach to the Efficacy of Antihypertensive Drugs in Reducing Blood Pressure

“…Furthermore, tihypertensive drugs including diuretics, has been hypothesized as the efficacy results of four agents (losartan, valsartan, irbesartan, due to direct, nondiuretic-dependent effects of indapamide SR on and candesartan cilexetil) are equivalent, a result that is also arterial function and structure. [89] comparable to that of Conlin et al [11] For DBP, the ↑-blocker therapeutic class is the most effective, The comparison of results for the diuretics considered here, followed by CCAs and diuretics, but the between-class and beindapamide SR and hydrochlorothiazide at a fixed dosage or with tween-drug differences are much less marked than for SBP (from a dosage increase, is in favor of indapamide SR, with a greater -9.0 to -12.2mm Hg). The ARB class appears to be the least drop in SBP and DBP.…”

Peculiarities of the influence of antihypertensive therapy on endothelial function, oxidative stress and immune activation in obese patients

“…3) reduction of the sensitivity of the arterial wall to catecholamines and angiotensin II (London, 2004).…”

Why Is Blood Pressure So Hard to Control in Patients With Type 2 Diabetes?

“…Risk reductions in the tight BP control group were 24% in diabetic‐related end points, 44% in strokes, and 37% in microvascular end points when compared with the less tightly controlled group. Although ACE inhibitors or ARBs are strongly recommended as first‐line agents in diabetic patients with albuminuria or renal impairment, using either of these drugs alone usually fails to achieve goal BP, 10,11,15 a circumstance that is true for all antihypertensive drug classes 14,16 . Thus, there is a paradox: diabetic hypertension is difficult to treat, but successful BP reduction is the most important element for preventing cardiovascular events 1,8 .…”