title: Comparison of the effects of diuretics on blood pressure and arterial stiffness in patients with stroke.
abstract: OBJECTIVE
  Indapamide (IND) and bendroflumethiazide (BDZ) are both widely used in patients with stroke. We compared their effects on arterial blood pressure (BP) and arterial stiffness in a group of patients with stroke.
  
  
  METHODS
  In a prospective, randomized, double-blinded study we investigated the effect of 28-day treatment with BDZ (2.5 mg once daily) or IND (2.5 mg once daily) on BP and arterial stiffness in a group of patients with first-ever ischemic stroke.
  
  
  RESULTS
  All data are expressed as mean (SD). In all, 23 patients completed the protocol (age 70.0 +/- 9.55 years). Group I (IND) and group B (BDZ) comprised 13 and 10 patients, respectively. Groups were well matched for demographics and baseline characteristics. Mean arterial pressure reduction from baseline was I = 14.3 +/- 10.3 mm Hg (P < .001) versus B = 9.1 +/- 11.2 mm Hg (P = .03). Augmentation index (AI) was reduced by: I = 4.94 +/- 7.22% (P = .037) versus B = 6.17 +/- 7.85% (P = .035). Time to reflection was increased by I = 3.22 +/- 9.57 milliseconds (P = .268) versus B = 4.71 +/- 5.30 milliseconds (P = .020). There was no significant difference between the two drugs with regard to change in BP or arterial stiffness. Pooled data showed a reduction in mean arterial pressure by 12.1 +/- 10.77 mm Hg (P < .0001) and in AI by 5.5 +/- 7.36% (P = .002), and a small increase in time to reflection by 3.9 +/- 7.79 milliseconds (P = .029). The change in BP explained up to 28% of the change in AI.
  
  
  CONCLUSIONS
  Both diuretics altered hemodynamic parameters to a similar extent. The results are consistent with a direct effect of diuretic therapy on vascular function. The influence of both diuretics on arterial stiffness was similar.
authors.affiliation: Division of Cardiovascular and Medical Sciences, Acute Stroke Unit, University of Glasgow, United Kingdom.
authors.forename: Manal
authors.initials: M
authors.lastname: Alem
authors.forename: Paolo
authors.initials: P
authors.lastname: Milia
authors.forename: Scott
authors.initials: S
authors.lastname: Muir
authors.forename: Kennedy
authors.initials: K
authors.lastname: Lees
authors.forename: Matthew
authors.initials: M
authors.lastname: Walters
mesh_terms: D000368:Aged; D001539:Bendroflumethiazide / Q000494:pharmacology; D001794:Blood Pressure / Q000187:drug effects* / Q000502:physiology; D002536:Cerebral Arteries / Q000187:drug effects / Q000503:physiopathology; D002560:Cerebrovascular Circulation / Q000187:drug effects / Q000502:physiology; D004232:Diuretics / Q000494:pharmacology*; D004311:Double-Blind Method; D004334:Drug Administration Schedule; D004548:Elasticity / Q000187:drug effects / Q000502:physiology; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000188:drug therapy* / Q000503:physiopathology*; D007190:Indapamide / Q000494:pharmacology; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D020521:Stroke / Q000188:drug therapy* / Q000209:etiology / Q000503:physiopathology*; D016896:Treatment Outcome; D014664:Vasodilation / Q000187:drug effects / Q000502:physiology
chemical_list: D004232:Diuretics; D001539:Bendroflumethiazide; D007190:Indapamide