Effects of indapamide versus hydrochlorothiazide on plasma lipids and lipoproteins in hypertensive patients: a direct comparison.
To test the claim that indapamide causes fewer adverse metabolic effects than hydrochlorothiazide (HCTZ), six months of treatment with HCTZ 25 mg/day was compared with six months of treatment with indapamide 2.5 mg in a randomized double-blind study of 44 patients with mild to moderate hypertension. Both drugs significantly reduced blood pressure, with no significant differences in the reduction of potassium and chloride; neither drug was associated with a significant change in plasma total cholesterol, high density lipoprotein (HDL), apolipoprotein A1, apolipoprotein B or the ratio of total cholesterol to HDL levels. Triglyceride levels increased significantly more with indapamide than with HCTZ (P=0.02). The two drugs had similar effects on blood pressure and serum potassium; neither drug affected plasma glucose. Claims that indapamide is superior to HCTZ appear unwarranted; in view of the substantial cost difference, this finding, if confirmed in larger studies, has important policy implications.
Spence
J D
JD
Stroke Prevention & Atherosclerosis Research Centre, London, Canada. dspence@rri.on.ca
Huff
M
M
Barnett
P A
PA
D000293:Adolescent; D000328:Adult; D000368:Aged; D000959:Antihypertensive Agents / Q000009:adverse effects* / Q000627:therapeutic use; D001055:Apolipoproteins B / Q000187:drug effects; D001794:Blood Pressure / Q000187:drug effects; D002784:Cholesterol / Q000097:blood; D004232:Diuretics / Q000009:adverse effects / Q000627:therapeutic use; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D006852:Hydrochlorothiazide / Q000009:adverse effects* / Q000627:therapeutic use; D006973:Hypertension / Q000097:blood / Q000188:drug therapy*; D007190:Indapamide / Q000009:adverse effects* / Q000627:therapeutic use; D008055:Lipids / Q000097:blood*; D008074:Lipoproteins / Q000097:blood / Q000187:drug effects*; D008297:Male; D008875:Middle Aged; D049993:Sodium Chloride Symporter Inhibitors / Q000009:adverse effects / Q000627:therapeutic use; D016896:Treatment Outcome; D014280:Triglycerides / Q000097:blood
D000959:Antihypertensive Agents; D001055:Apolipoproteins B; D004232:Diuretics; D008055:Lipids; D008074:Lipoproteins; D049993:Sodium Chloride Symporter Inhibitors; D014280:Triglycerides; D006852:Hydrochlorothiazide; D002784:Cholesterol; D007190:Indapamide