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Comparative assessment of antihypertensive efficacy of Indapamide-retard and hydrochlorothiazide in hypertonic patients, uncontrolled RAAS blocker monotherapy

Kobalava Zh. D., Kotovskaya Yu. V., Pavlova E. A.

Keywords: antihypertensive ther apy, hyperpiesis, hydrochlorothiazide, indapamide, tr eatment, RAAS

DOI: 10.18087/rhj.2013.1.1798

Relevance. Use of outpatient BP registration methods allows reveal patient groups with latent inadequate treatment efficiency, characterized by adverse forecast and requiring stronger antihypertensive therapy. Objective. Comparison of efficiency and safety of introduction hydrochlorothiazide or indapamide retard to monotherapy by ACE inhibitor or ARB blocker concerning clinical BP and indicators of 24‑hour BP monitoring. Materials and methods. 44 patients were included to the research with level clinical BP >150 / 90 mm Hg and 24‑hour BP >135 / 85 mm Hg against ACE inhibitor or ARB blocker monotherapy in the maximum recommended doses within not less than 6 weeks. Patients were randomized for open-label administration of hydrochlorothiazide 25 mg / day or indapamide retard 1.5 mg / day for 12 weeks. Before prescription of diuretics and in 2, 4, 8, and 12 weeks of the combined therapy, serum creatinine, potassium, uric acid, and plasma glucose fasting levels were detected, GFR was calculated by MDRD formula. Results. The study showed high efficiency of free combinations RAAS blockers with indapamide retard 1.5 mg or hydrochlorothiazide 25 mg concerning achievement of clinical BP control. The antihypertensive effect of combinations was characterized by low frequency of the latent treatment inefficiency evaluated based on clinical and 24‑hour BP comparison. Combination treatment was accompanied by a comparable tolerance and safety profile concerning renal function, potassium and metabolic levels. Conclusion. Advantages of indapamide retard 1.5 mg comparison with hydrochlorothiazide as the second agent are faster achievement of the target clinical BP, decrease of BP variability from visit to visit, more expressed decrease of night BP with increased expressiveness of BP diphasic rhythm.
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Kobalava Zh. D., Kotovskaya Yu. V., Pavlova E. A. Comparative assessment of antihypertensive efficacy of Indapamide-retard and hydrochlorothiazide in hypertonic patients, uncontrolled RAAS blocker monotherapy. Russian Heart Journal. 2013;12(1):42-47

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