Comparative Trial of Indapamide and Hydrochlorothiazide in Essential Hypertension, with Forearm Plethysmography

Jh, Kreeft; Langlois, Simon; Ri, Ogilvie

doi:10.1097/00005344-198407000-00011

Cited by 16 publications

(6 citation statements)

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“…Several studies have shown IND to be equally effective as thiazide-based regimens in controlling BP in patients with mild to moderate hypertension requiring only single-drug therapy [3,4]. The results of the present study demonstrated that IND and HCTZ + A had the same potency in reducing BP when added as the third drug in patients with more advanced hypertensive disease.…”

Section: Discussionsupporting

confidence: 59%

Comparison of indapamide and hydrochlorothiazide plus amiloride as a third drug in the treatment of arterial hypertension

Poulsen

Friberg

Noer

et al. 1989

Cardiovasc Drug Ther

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In a randomized, double-blind crossover trial, indapamide (IND) 2.5 mg and hydrochlorothiazide 25 mg + amiloride 2.5 mg (HCTZ + A) were found to be equally effective in reducing blood pressure (BP) in 13 patients with moderate to severe hypertension already receiving chronic treatment with a beta blocker and a vasodilatator (supine BP during run-in: 169/103 +/- 21/5 mmHg; on IND: 149/91 +/- 21/14 mmHg; on HCTZ + A 144/88 +/- 23/5 mmHg). Both drugs induced insignificant reductions in body weight, and no change in plasma volume was seen. Serum potassium was significantly reduced on both regimens--the values recorded on IND being significantly lower than those seen on HCTZ + A. Values below 3.0 mmol/l were found in two patients receiving IND, but no subjective side effects were reported. Hyperuricemia occurred with the same frequency on both regimens. It is concluded that IND, just like the thiazide diuretics, is useful as the third drug in patients needing triple drug therapy to control BP, but metabolic adverse effects are not avoided by the choice of this drug.

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Section: Discussionsupporting

confidence: 59%

Comparison of indapamide and hydrochlorothiazide plus amiloride as a third drug in the treatment of arterial hypertension

Poulsen

Friberg

Noer

et al. 1989

Cardiovasc Drug Ther

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“…It is important to note that the thiazide doses used in these infusions resulted in plasma concentrations of 11 μg/ml, which is approximately 10–20 times the plasma concentration found in patients clinically treated with thiazides [23,24]. Moreover, these findings were contrary to previous studies, which did not find any vasoactivity in the human forearm, although such studies used doses more comparable to those found in clinical practice [25,26]. Last, the difference in thiazide-induced vasodilation did not appear to vary between hypertensives and normotensives [22].…”

Section: Antihypertensive Effectsmentioning

confidence: 77%

Mechanisms for blood pressure lowering and metabolic effects of thiazide and thiazide-like diuretics

Duarte

Cooper‐DeHoff

2010

Expert Review of Cardiovascular Therapy

187

131

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Thiazide and thiazide-like diuretics are among the most commonly used antihypertensives and have been available for over 50 years. However, the mechanism by which these drugs chronically lower blood pressure is poorly understood. Possible mechanisms include direct endothelial- or vascular smooth muscle-mediated vasodilation and indirect compensation to acute decreases in cardiac output. In addition, thiazides are associated with adverse metabolic effects, particularly hyperglycemia, and the mechanistic underpinnings of these effects are also poorly understood. Thiazide-induced hypokalemia, as well as other theories to explain these metabolic disturbances, including increased visceral adiposity, hyperuricemia, decreased glucose metabolism and pancreatic β-cell hyperpolarization, may play a role. Understanding genetic variants with differential responses to thiazides could reveal new mechanistic candidates for future research to provide a more complete understanding of the blood pressure and metabolic response to thiazide diuretics.

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“…Adapted with permission from [55]. Studies: Elliott et al [56], Malini et al [57], Spence et al [58], Emeriau et al [59], Kreeft et al [60], Madkour et al [61], Plante et al [62], Plante et al [63], Krum et al [64], Radevski et al [65], Ernst et al [51], Kwon et al [66], Pareek et al [67]. Differences in means and 95% CI are presented.…”

Section: Selecting Thiazide-like Diuretics Over Thiazide Diureticsmentioning

confidence: 99%

Redefining diuretics use in hypertension

Burnier

Bakris

Williams

2019

Journal of Hypertension

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Diuretics are listed in hypertension guidelines as one of three equally weighted first-line treatment options. In order to differentiate between antihypertensives, a lot of discussion has been directed at side effect profiles and as a result, has created a perhaps disproportionate fear of the metabolic effects that can be associated with diuretics. Data, however, show that the risk of a clinically meaningful change in laboratory parameters is very low, whereas the benefits of volume control and natriuresis are high and the reductions in morbidity and mortality are clinically significant. Moreover, as clinically significant differences in safety and efficacy profiles exist among diuretics, several international guidelines have started making a distinction between thiazides (hydrochlorothiazide) and thiazide-like (chlorthalidone, indapamide) diuretics; and some of them now recommend longer acting thiazide-like diuretics. In time, pending more data, chlorthalidone and indapamide may need to be subdivided further into separate classifications.

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Comparative Trial of Indapamide and Hydrochlorothiazide in Essential Hypertension, with Forearm Plethysmography

Cited by 16 publications

References 0 publications

Comparison of indapamide and hydrochlorothiazide plus amiloride as a third drug in the treatment of arterial hypertension

Comparison of indapamide and hydrochlorothiazide plus amiloride as a third drug in the treatment of arterial hypertension

Mechanisms for blood pressure lowering and metabolic effects of thiazide and thiazide-like diuretics

Redefining diuretics use in hypertension

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