What can be learned from the experience with the fixed low-dose combination of perindopril/indapamide in the treatment of hypertension?
The association of low doses of perindopril and indapamide in a single pill has been developed to meet the criteria required for a fixed-dose combination to be used as first-line therapy. The experience accumulated so far has demonstrated a greater antihypertensive efficacy of this preparation compared with various monotherapies, but not at the expense of a worsening of tolerability. The perindopril/indapamide combination is particularly effective in lowering systolic and pulse blood pressure. Starting treatment with this fixed-dose combination improves arterial stiffness and allows a better regression of cardiac hypertrophy than angiotensin-converting enzyme-inhibition or beta-adrenoceptor blockade alone. In hypertensive patients with Type 2 diabetes, a greater reduction of urinary albumin excretion can be obtained with the perindopril/indapamide association compared with an angiotensin-converting enzyme inhibitor administered as monotherapy. There is evidence that a first-line management of hypertension based on a low-dose perindopril/indapamide combination can provide a better efficacy/safety ratio than other well-established therapeutic strategies.
Waeber
Bernard
B
Division of Clinical Pathophysiology, University Hospital, Lausanne, Switzerland. Bernard.Waeber@chuv.hospvd.ch
D000284:Administration, Oral; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000008:administration & dosage / Q000627:therapeutic use*; D001794:Blood Pressure / Q000187:drug effects; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000188:drug therapy; D004232:Diuretics / Q000008:administration & dosage / Q000627:therapeutic use*; D004334:Drug Administration Schedule; D004338:Drug Combinations; D006331:Heart Diseases / Q000150:complications / Q000188:drug therapy; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000188:drug therapy*; D007190:Indapamide / Q000008:administration & dosage / Q000627:therapeutic use*; D007674:Kidney Diseases / Q000209:etiology / Q000517:prevention & control; D020913:Perindopril / Q000008:administration & dosage / Q000627:therapeutic use*
D000806:Angiotensin-Converting Enzyme Inhibitors; D004232:Diuretics; D004338:Drug Combinations; D007190:Indapamide; D020913:Perindopril