The effect of indapamide versus hydrochlorothiazide on ventricular and arterial function in patients with hypertension and diabetes: results of a randomized trial.

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  • Additional Information
    • Source:
      Publisher: Mosby Country of Publication: United States NLM ID: 0370465 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1097-6744 (Electronic) Linking ISSN: 00028703 NLM ISO Abbreviation: Am Heart J Subsets: MEDLINE
    • Publication Information:
      Original Publication: St. Louis, MO : Mosby
    • Subject Terms:
      Carotid Arteries/*physiopathology ; Diabetes Mellitus, Type 2/*complications ; Hydrochlorothiazide/*administration & dosage ; Hypertension/*drug therapy ; Indapamide/*administration & dosage ; Vascular Resistance/*drug effects ; Ventricular Function/*drug effects; Blood Pressure/drug effects ; Carotid Arteries/diagnostic imaging ; Carotid Arteries/drug effects ; Diuretics/therapeutic use ; Dose-Response Relationship, Drug ; Echocardiography, Doppler ; Female ; Follow-Up Studies ; Humans ; Hypertension/complications ; Hypertension/physiopathology ; Male ; Middle Aged ; Prospective Studies ; Single-Blind Method ; Treatment Outcome ; Ultrasonography, Doppler, Color
    • Abstract:
      Objective: The objective of this study is to compare the effects of 2 types of diuretics, indapamide and hydrochlorothiazide, added to an angiotensin-converting enzyme inhibitor, on ventricular and arterial functions in patients with hypertension and diabetes.
      Methods: This is a prospective, randomized, active-controlled, PROBE design study in 56 patients (57 ± 9 years, 52% men) with mild-to-moderate hypertension and type 2 diabetes, with normal ejection fraction, randomized to either indapamide (1.5 mg Slow Release (SR)/day) or hydrochlorothiazide (25 mg/d), added to quinapril (10-40 mg/d). All patients had conventional, tissue Doppler and speckle tracking echocardiography and assessment of endothelial and arterial functions and biomarkers, at baseline and after 6 months.
      Results: Baseline characteristics were similar between groups; systolic and diastolic blood pressures decreased similarly, by 15% and 9% on indapamide and by 17% and 10% on hydrochlorothiazide (P < .05). Mean longitudinal systolic velocity and longitudinal strain increased by 7% and 14% on indapamide (from 5.6 ± 1.8 to 6.0 ± 1.1 cm/s and from 16.2% ± 1.8% to 18.5% ± 1.1%, both P < .05), but did not change on hydrochlorothiazide (P < .05 for intergroup differences), whereas ejection fraction and radial systolic function did not change. Similarly, mean longitudinal early diastolic velocity increased by 31% on indapamide (P < .05), but did not change on hydrochlorothiazide (P < .05 for intergroup differences). These changes were associated with improved endothelial and arterial functions on indapamide, but not on hydrochlorothiazide.
      Conclusion: Indapamide was found to improve measures of endothelial and arterial functions and to increase longitudinal left ventricular function compared with hydrochlorothiazide in patients with hypertension and diabetes, after 6 months of treatment. This study suggests that indapamide, a thiazide-like diuretic, has important vascular effects that can improve ventriculoarterial coupling.
      (Copyright © 2014 Mosby, Inc. All rights reserved.)
    • Accession Number:
      0 (Diuretics)
      0J48LPH2TH (Hydrochlorothiazide)
      F089I0511L (Indapamide)
    • Publication Date:
      Date Created: 20140929 Date Completed: 20150224 Latest Revision: 20161125
    • Publication Date:
      20221213
    • Accession Number:
      10.1016/j.ahj.2014.06.010
    • Accession Number:
      25262253