2014


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2014/№6

Study for comparative evaluation of Trigrim and Arifon Retard efficacy and safety in patients with arTerial hypertension in a parallel group, blind, randomized study (study START)

Sviryaev Yu.V., Zvartau N.E., Korostovtseva L.S., Semenov A.P., Konradi A.O.
Federal State Budgetary Institution “V. A. Almazov Federal Medical Research Center” of the RF Ministry of Health Care, Akkuratova 2, St.-Petersburg 197341

Keywords: arterial hypertension, diuretics, treatment


DOI: 10.18087/rhj.2014.6.2017

Background. Diuretics are almost the oldest class of drugs used for treatment of arterial hypertension (AH). Generally, the antihypertensive therapy with diuretics includes thiazide and / or thiazide-like diuretics. However, some recent studies have demonstrated efficacy of loop diuretics for the treatment of AH. Aim. To compare efficacy of torasemide (Trigrim) and indapamide retard (Arifon Retard) in patients with grade 1–2 AH in a blind randomized study. Materials and methods. The study included 60 patients with grade 1–2 AH, 48 men and 12 women (mean age, 52±15). The study was blind, and codes were disclosed after the study completion. Standardized therapy implied titration of torasemide dose at the third of four visits; the highest torasemide dose was 5 mg / day and the highest indapamide retard dose was 1.5 mg. Efficacy endpoints were decreased systolic BP (SBP) and diastolic BP (DBP) below 140 / 90 mm Hg in office measurement and below 130 / 80 mm Hg in 24‑h BP monitoring (24‑h BPM). Prior to the treatment onset and until the study completion, clinical and laboratory-instrumental examinations were performed. Treatment period was 12 weeks. Results. Comparative analysis performed after the study completion and treatment code disclosure showed that the treatment with loop diuretic, torasemide effectively reduced SBP and DBP compared to baseline values in «office» measurement (10.7 and 8.8 %, respectively). The torasemide treatment was associated with decreased SBP (from 149.6±9.9 to 134±6.3 mm Hg, p<0.01) and DBP (from 90.5±3.6 to 83±5.3 mm Hg, p<0.01). According to self-monitoring diaries, office SBP and DBP were reducing faster in patients receiving torasemide. Conclusion. The treatment of grade 1 and 2 AH patients with the loop diuretic, torasemide in the comparative, blind, randomized study, effectively reduced SBP and DBP from baseline values, allowed faster achievement of target BP, and did not affect the lipid profile, glycemia, and electrolyte levels. Therefore, this treatment can be recommended for more extensive use in combination therapy for AH and in patients of special groups (isolated systolic AH and elderly).
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Sviryaev Yu. V., Zvartau N. E., Korostovtseva L. S. et al. Study for comparative evaluation of Trigrim and Arifon Retard efficacy and safety in patients with arTerial hypertension in a parallel group, blind, randomized study (study START). Russian Heart Journal. 2014;13 (6):389–395

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