Equivalence of indapamide SR and enalapril on microalbuminuria reduction in hypertensive patients with type 2 diabetes

Marre, Michel; Puig, Juan; Kokot, F; Fernández, M; Jermendy, György; Opie, Lionel H.; Moyseev, Valentin; Scheen, André; Ionescu-Tîrgovişte, C; Saldanha, Maria Helena; Halabe, A.; Williams, Bryan; Mion, Décio; Ruiz, M; Hermansen, Kjeld; Tuomilehto, Jaakko; Finizola, Bartolomé; Gallois, Yves; Amouyel, Philippe; Ollivier, Jean‐Pierre; Asmar, Roland

doi:10.1097/01.hjh.0000133733.32125.09

Cited by 131 publications

(75 citation statements)

References 37 publications

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“…34,40,[46][47][48][56][57][58][59] Clinical trials, grouped by the degree of albuminuria, demonstrating the beneficial effects of RAAS inhibition on renal end points in patients with diabetes mellitus are summarized in Table 2. 34,40,42,48,49,[57][58][59][60][61][62][63][64][65][66][67][68][69][70][71] Normoalbuminuria The Bergamo Nephrologic Diabetes Complications Trial (BENEDICT) is the only primary prevention study to date to demonstrate that the development of microalbuminuria can be prevented by the use of an ACE inhibitor alone or in combination with a CCB in hypertensive normoalbuminuric patients with type II diabetes. 59 …”

Section: Clinical Evidence Of Benefits Of Raas Inhibition In Patientsmentioning

confidence: 99%

“…70,71 Studies of diuretics (alone or in combination with an ACE inhibitor) suggest possible renoprotective benefits. 64,68 A low-dose combination of perindopril plus indapamide induced a greater decrease in UAER (À42%) than once-daily monotherapy with enalapril (À27%) in diabetic patients with hypertension and albuminuria. 68 This advantage remained after adjustment for the lower BP achieved by the combination group and for other factors.…”

Section: Multifaceted Approachesmentioning

confidence: 99%

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Evidence for renoprotection by blockade of the renin–angiotensin–aldosterone system in hypertension and diabetes

Karalliedde

Viberti

2006

J Hum Hypertens

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The incidence of end-stage renal disease (ESRD) is rising worldwide, accompanied by corresponding increases in the risk of morbidity and mortality. Underlying this trend are increasing rates of hypertension and diabetes mellitus, the two most common causes of ESRD. In addition to the adverse haemodynamic effects of hypertension on the kidney, elevated blood pressure (BP) can activate components of the renin-angiotensinaldosterone system (RAAS), which, in turn, activate mediators of inflammation, oxidative stress, cell growth, and matrix accumulation. Lowering BP reduces the risk of cardiovascular events and renal damage. Accumulating evidence from clinical and laboratory studies suggests that interrupting the RAAS with therapies such as angiotensin-converting enzyme inhibitors, angiotensin II receptor blockers, and aldosterone receptor blockers can interfere with the mechanisms that promote diabetic and non-diabetic renal damage. Moreover, clinical trials of RAAS blockade have demonstrated reductions in microalbuminuria, a predictor of increased cardiorenal risk and overt nephropathy in patients with and without diabetes and/or hypertension. In this way, agents that block the RAAS should be considered the drugs of first choice as they provide enhanced renoprotection compared with other classes of antihypertensive agents such as calcium channel blockers and b-blockers.

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Section: Clinical Evidence Of Benefits Of Raas Inhibition In Patientsmentioning

confidence: 99%

Section: Multifaceted Approachesmentioning

confidence: 99%

Evidence for renoprotection by blockade of the renin–angiotensin–aldosterone system in hypertension and diabetes

Karalliedde

Viberti

2006

J Hum Hypertens

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“…The Natrilix SR versus enalapril study in hypertensive type 2 diabetics with microalbuminuria (NESTOR) set out to compare the effectiveness of two antihypertensive drugs: an ACEI, enalapril, and a diuretic, indapamide sustained release (SR) 12 with opposite effects on the reninangiotensin system (RAS) in reducing microalbuminuria. 13 Results of the study suggested that indapamide SR and enalapril reduced microalbuminuria to a similar extent, with equivalent mean BP control.…”

mentioning

confidence: 72%

Efficacy of Indapamide SR Compared With Enalapril in Elderly Hypertensive Patients With Type 2 Diabetes

Puig

Marre

Kokot³

et al. 2007

American Journal of Hypertension

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Background: Blood pressure control is the main influential variable in reducing microalbuminuria in patients with type 2 diabetes. In this subanalysis of the Natrilix SR versus Enalapril Study in hypertensive Type 2 diabetics with micrOalbuminuRia (NESTOR) study, we have compared the effectiveness of indapamide sustained release (SR) and enalapril in reducing blood pressure and microalbuminuria in patients ≥65 years of age.

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“…An additional label treatment by amlodipine 5-10 mg (first step) and atenolol 50-100 mg (second step)/day was allowed after 6 weeks of treatment. 24 Results showed that the decrease in SBP was significantly (P ¼ 0.02) more important with indapamide SR (À23.8 mmHg) than with enalapril (À21.0 mmHg), Figure 2. The noninferiority of indapamide SR vs enalapril was achieved for microalbuminuria reduction.…”

Section: Sbp Lowering In Hypertensive Patients With Type II Diabetes-mentioning

confidence: 92%

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

London¹

2004

J Hum Hypertens

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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.

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Equivalence of indapamide SR and enalapril on microalbuminuria reduction in hypertensive patients with type 2 diabetes

Abstract: Indapamide-SR-based therapy is equivalent to enalapril-based therapy in reducing microalbuminuria with effective blood pressure reduction in patients with hypertension and type 2 diabetes.

Cited by 131 publications

References 37 publications

Evidence for renoprotection by blockade of the renin–angiotensin–aldosterone system in hypertension and diabetes

Evidence for renoprotection by blockade of the renin–angiotensin–aldosterone system in hypertension and diabetes

Efficacy of Indapamide SR Compared With Enalapril in Elderly Hypertensive Patients With Type 2 Diabetes

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

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