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Indapamide is not only a diuretic


Authors: Špinarová L. 1;  Špinar J. 2;  Vítovec J. 1
Authors‘ workplace: I. interní kardioangiologická klinika LF MU a FN u sv. Anny v Brně 1;  Ústav lékařské fyziologie, LF MU Brno 2
Published in: Kardiol Rev Int Med 2019, 21(4): 209-212

Overview

Indapamide is not only a simple diuretic, but also a vasodilating substance which acts through the prostaglandines and increases calcium inflow into the myocytes. It is metabolic neutral and does not influence the level of glucose or lipids. It decreases the blood pressure and in combination with perindopril also has mortality evidence from the clinical trials HYVET and ADVANCE. Cerebroprotective data are in the PROGRESS trial. Two recent meta-analyses show data about the effect on regression of left ventricular hypertrophy, which is more pronounced than with hydrochlorothiazide. The decrease of blood pressure is a basic but not the only criterion for the treatment of hypertension. If we decide on the usage of diuretics, indapamide should be preferred.

Keywords:

hypertension – indapamide – left ventricular hypertrophy – patient prognosis


Sources

1. Raggi U, Palumbo P, Moro B et al. Indapamide in the treatment of hypertension in non-insulin-dependent diabetes. Hypertension 1985; 7(6 Pt 2): 157– 160. doi: 10.1161/ 01.hyp.7.6_pt_2.ii157.

2. Madkour H, Gadal­lah M, Riveline B et al. Indapamide is superior to thiazide in the preservation of renal function in patients with renal insuf­ficiency and systemic hypertension. Am J Cardiol 1996; 77(6): 23B– 25B. doi: 10.1016/ s0002-9149(97)89236-3.

3. Beckett NS, Peters R, Fletcher AE et al. Treatment of hypertension in patients 80 years of age or older. N Engl J Med 2008; 358(18): 1887– 1898. doi: 10.1056/ NEJMoa0801369.

4. Patel A, MacMahon S, Chalmers J et al. ADVANCE Col­laborative Group. Ef­fects of a fixed combination of perindopril and indapamide on macrovascular and microvascular outcomes in patients with type2 diabetes mel­litus (the ADVANCE trial): a randomised control­led trial. Lancet 2007; 370(9590): 829– 840. doi: 10.1016/ S0140-6736(07)61303-8.

5. PROGRESS Col­laborative Group. Randomised trial of a perindopril-based blood-pres­sure-lower­­ing regimen among 6,105 individuals with previous stroke or transient ischaemic attack. Lancet 2001; 358(9287): 1033– 1041. doi: 10.1016/ S0140-6736(01)06178-5.

6. Roush GC, Abdelfattah R, Song S et al. Hydrochlorothiazide vs. chlorthalidone, indapamide and potas­sium-sparing/ hydrochlorothiazide diuretics for reduc­­ing left ventricular hypertrophy: A systematic review and metaanalysis. J Clin Hypertens 2018; 20(10): 1507– 1515. doi: 10.1111/ jch.13386.

7. Roush GC, Abdelfattah R, Song S et al. Hydrochlorothiazide and alternative diuretics versus renin –  angiotensin system inhibitors for the regres­sion of left ventricular hypertrophy: a head- to- head meta-analysis. J Hypertens 2018; 36(6): 1247– 1255. doi: 10.1097/ HJH.0000000000001691.

Labels
Paediatric cardiology Internal medicine Cardiac surgery Cardiology
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