[Comparative assessment of hypotensive, metabolic, and endothelial effects of indapamide-retard and hydrochlorothiazide in patients with essential hypertension].
OBJECTIVE
To compare hypotensive, metabolic, and endothelial effects of indapamide-retard and hydrochlorothiazide.


METHODS
Patients (n=50) with essential hypertension were given either indapamide-retard (1.5 mg/day, n=25) or hydrochlorothiazide (25 mg/day, n=25) for 12 weeks. Dynamics of the following parameters were studied: blood pressure, blood lipids and glucose, total coronary risk, carotid artery intima-media thickness, reaction of brachial artery to endothelium-dependent and endothelium-independent stimuli registered by high resolution ultrasound.


RESULTS
Indapamide-retard and hydrochlorothiazide demonstrated similar hypotensive efficacy. Indapamide-retard turned out to be metabolically neutral while in patients receiving hydrochlorothiazide we observed significant elevation of triglycerides (+15.3%, p<0.05) and glucose (+12.2%, p<0.05). This resulted in the lack of lowering of total coronary risk during treatment with hydrochlorothiazide. Significant intergroup differences were revealed in effects on endothelium-dependent vasodilation with tendency to improvement and to significant worsening (-17%, p<0.05) in indapamide and hydrochlorothiazide treated patients, respectively.


CONCLUSIONS
Despite similar hypotensive efficacy there were significant differences in metabolic and endothelial effects of 2 diuretics in favor of indapamide. This could potentially matter for long term cardiovascular prognosis.
Semenkin
A A
AA
Zhivilova
L A
LA
Golevtsova
Z Sh
ZSh
Protskiĭ
I A
IA
Nazarov
A G
AG
Potapov
V V
VV
Pritykina
T V
TV
D000368:Aged; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D001786:Blood Glucose / Q000187:drug effects / Q000378:metabolism*; D001794:Blood Pressure / Q000187:drug effects; D001916:Brachial Artery / Q000000981:diagnostic imaging / Q000187:drug effects / Q000503:physiopathology; D004730:Endothelium, Vascular / Q000187:drug effects* / Q000503:physiopathology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006852:Hydrochlorothiazide / Q000627:therapeutic use*; D006973:Hypertension / Q000097:blood / Q000188:drug therapy* / Q000503:physiopathology; D007190:Indapamide / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome; D014280:Triglycerides / Q000097:blood*; D014463:Ultrasonography; D014664:Vasodilation / Q000187:drug effects
D000959:Antihypertensive Agents; D001786:Blood Glucose; D014280:Triglycerides; D006852:Hydrochlorothiazide; D007190:Indapamide