Summary
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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References
Finnerty FA, Davidov M, Mroczek WJ, Gavriovich L. Influence of extracellular fluid volume on response to antihypertensive drugs.Circ Res 1970; 26+27(Suppl I):I71–I82.
Ibsen H, Rasmussen K, Jensen HE, Leth A. Changes in plasma volume and extracellular fluid volume after addition of hydralazine to propranolol treatment in patients with hypertension.Acta Med Scand 1978; 203:419–423.
Chaffman M, Heel RC, Brogden RN, Speight TM, Avery GS. Indapamide. A review of its pharmacodynamic properties and therapeutic efficacy in hypertension.Drugs 1984; 28:189–235.
Kreeft JH, Langlois S, Ogilvie RI. Comparative trial of hydrochlorothiazide in essential hypertension, with forearm plethysmography.J Cardiovasc Pharmacol 1984; 6:622–626.
Krusell LR, Jespersen LT, Schmitz A, Thomsen L, Lederballe Pedersen O. Repetitive natriuresis and blood pressure. Long-term calcium entry blockade with isradipine.Hypertension 1987; 10:577–581.
Capuccio FP, Markandu ND, Tucker F, Sagnella GA, MacGregor A. Does a diuretic cause a further fall in blood pressure in hypertensive patients already on nifedipine?J Clin Hypertens 1986; 4:346–353.
Husted SE, Nielsen HK, Christensen CK, Lederballe Pedersen O. Long-term therapy of arterial hypertension with nifedipine given alone or in combination with a betaadrenoceptor blocking agent.Eur J Clin Pharmacol 1982; 22:101–103.
Krusell LR, Christensen CK, Lederballe Pedersen O. Renal effects of pinacidil in hypertensive patients on chronic betablocker therapy.Eur J Clin Pharmacol 1986; 30:641–647.
Krusell LR, Jespersen LT, Lederballe Pedersen O. Effects of doxazasin on renal function in patients with mild to moderate hypertension. Submitted for publication.
Danielsen H, Pedersen EB, Spencer ES. Effect of indapamide on the renin-aldosterone system, and urinary excretion of potassium and calcium in essential hypertension.Br J Clin Pharmacol 1984; 18:229–231.
Plante GE, Lafreniere M-C, Tam PT, Sirois P. Effect of indapamide on phosphate metabolism and vascular reactivity.Am J Med 1988; 84(Suppl 1B):26–30.
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Poulsen, L., Friberg, M., Noer, I. et al. Comparison of indapamide and hydrochlorothiazide plus amiloride as a third drug in the treatment of arterial hypertension. Cardiovasc Drug Ther 3, 141–144 (1989). https://doi.org/10.1007/BF01883857
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DOI: https://doi.org/10.1007/BF01883857