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PubMed1981

The antihypertensive action of indapamide: results of a French multicentre study of 2,184 ambulant patients.

A multicentre study was carried out by 300 French general practitioners to evaluate the efficacy and acceptability of indapamide in a single daily dose of 2.5 mg in 2,184 patients with essential hypertension. There was a significant reduction in blood pressure, 65.7% of the patients attaining a normal blood pressure. In addition, it was found that indapamide produced an excellent reduction in blood pressure in severely hypertensive patients, including those on combined therapy with a beta-blocker. The elderly patients were found to benefit from the simple dosage and the lack of side effects such as postural hypotension. There was little change in any of the biochemical measurements.

Adrenergic beta-Antagonists↗
PubMed1983

Multicenter dose-response study of the effect of indapamide in the treatment of patients with mild to moderate hypertension.

This study, carried out in three centers in the United States, investigated the antihypertensive effect of three dosages of indapamide in 87 patients with mild to moderate hypertension. The dosages studied were 1 mg, 2.5 mg, and 5 mg daily. A double-blind, parallel study design was used with a six-week placebo run-in period followed by an eight-week treatment period and a two-week follow-up period. Compared with placebo, all dosages caused a significant decrease (P less than 0.05) in blood pressure, with an average decrease of approximately 6 mmHg diastolic and 13 mmHg systolic. The antihypertensive effect seemed to be fully manifest after six weeks of treatment. At all dosage levels, indapamide produced markedly greater therapeutic success rates than did the placebo. Success was defined as either a standing phase-5 diastolic blood pressure of less than 90 mmHg or a decrease by at least 10 mmHg from baseline. Although the decrease in mean serum potassium concentration was dose-related, the decrease was not clinically significant with any dose. A reduction in serum chloride and increases in serum uric acid and glucose were also observed. These changes were slight and did not cause the discontinuation of treatment for any patient. The most frequently observed side effects were mild to moderately severe dizziness, weakness, and headaches.

Adult↗
PubMed1983

The antihypertensive effect of indapamide.

Fourteen patients with moderately severe essential hypertension were treated for 8 weeks with indapamide 2,5 mg/d. Systolic and diastolic blood pressures fell significantly from the 1st week of treatment; the rapid changes noted thereafter were described mathematically by decreasing power functions of time. Serum potassium and blood glucose values did not change significantly. Indapamide behaves as a power antihypertensive diuretic which appears safe at low doses and can be considered for the first-line treatment of essential hypertension.

Aged↗
PubMed1981

Indapamide in the treatment of essential arterial hypertension in the elderly.

Twenty-four patients (average age 72 years) took part in a study of the effectiveness and tolerance of indapamide as medication for essential hypertension in elderly subjects. 2.5 mg was administered daily for two months, after which the same amount was given once every other day in order to investigate whether the antihypertensive effect would persist at this dosage. After two months treatment with 1 tablet of indapamide 2.5 mg daily, statistically significant (P less than 0.01) drops in the mean systolic and diastolic blood pressures both erect and supine were observed. In 18 of the patients, the results obtained underwent no statistically significant modifications during the second 2-month treatment period at reduced dosage. In 5 others, dosage had to be maintained at 1 tablet daily. In all cases, the drug was well tolerated clinically. ECG recordings were unchanged. Laboratory results remained within the normal range despite a slight increase in serum uric acid and a slight decrease in potassium.

Aged↗
PubMed1981

A study comparing indapamide with cyclopenthiazide in geriatric patients.

The efficacy of indapamide was compared with cyclopenthiazide in geriatric hypertensive patients. On admission to the study patients were randomly allocated following a placebo run-in period before therapy commenced. Indapamide produced a greater fall in blood pressure which was well maintained in contrast to cyclopenthiazide. Both drugs were well tolerated.

Aged↗
PubMed1981

Comparison of the antihypertensive effects of indapamide and metoprolol.

The effects on blood pressure and heart rate of 200 mg metoprolol and 2.5 mg indapamide given separately and together as a single daily dose were compared in 27 patients suffering from moderate hypertension. The blood pressure and heart rate were measured in the lying and standing position, before, during and after exercise. Both indapamide and metoprolol in a single daily dose reduced the blood pressure. The best results were achieved by a combination of the two.

Adult↗
PubMed1981

A multicentre open trial indapamide in general practice.

In a multicentre open study, 99 patients were treated with indapamide (2.5 mg daily) by 19 general practitioners. Fourteen patients failed to complete the study and in most cases this was unrelated to active therapy. Fifty patients had not previously received antihypertensive therapy, 25 patients had been on previous antihypertensive therapy with either unsatisfactory blood pressure control of side effects and the remaining 10 patients had indapamide added to their existing therapy. Of the 85 patients who did complete, the mean reduction in blood pressure at the end of 4 months treatment was 26 mmHg systolic and 17 mmHg diastolic. In those patients who were studied for at least 12 months treatment, blood pressure control was maintained in the majority. No severe side effects were reported.

Adult↗
PubMed1981

International multicentre study of indapamide in the treatment of essential arterial hypertension.

A total of 1600 patients with essential arterial hypertension was recruited from 10 countries, and treated with indapamide according to a common protocol. 703 subjects who completed the protocol were analysed, from whom 644 were followed for 3 months, and the remainder (all from Belgium) up to 10 months. The group of 644 showed a highly significant drop in erect and supine blood pressures after one month, and this was maintained after 3 months treatment. The percentage of responders (normalization of diastolic pressure, or drop of at least 30 mmHg) was 64% after 3 months. The Belgian group maintained their reductions in pressure at 6 and 10 months. Serum potassium showed a modest drop, but remained within normal limits: other biochemical values were virtually unchanged. Some side effects were noted, but none was serious. It is concluded that indapamide is a first line treatment for essential arterial hypertension.

Adolescent↗
PubMed1981

Non-invasive cardiovascular assessment of indapamide in patients with essential hypertension.

The antihypertensive effect and a non-invasive cardiovascular assessment of indapamide in patients with idiopathic hypertension have been investigated in an uncontrolled study. Indapamide was found to be an effective antihypertensive agent in a dose of 2.5 mg per day with a mean fall in blood pressure of 25/18 mmHg. Apart from the development of impotence in one patient, no side effects were encountered. Its effect on heart rate and cardiac output suggest that vasodilatation may contribute to its mode of action. Exercise performance is well maintained and cardiac performance appears to improve when blood pressure is lowered with this drug.

Adult↗
PubMed1981

Comparison of the antihypertensive effects of indapamide and cyclopenthiazide.

The antihypertensive effects of indapamide, 2.5 mg, and cyclopenthiazide, 0.5 mg daily were compared over a two week period. The falls in both diastolic and systolic blood pressure were greater with indapamide than with cyclopenthiazide reaching statistical significance for the supine diastolic values. This difference was still seen when matching patient groups of similar age, sex or severity of blood pressure were compared.

Antihypertensive Agents↗
PubMed1993

Reactivity and sensitivity of the mesenteric artery in adult spontaneously hypertensive rats after chronic treatment with indapamide.

The effects of chronic treatment with indapamide (3 mg/kg/day) on the structure and function of the mesenteric artery were studied in two groups of spontaneously hypertensive rats (SHRs) using an experimental model of in situ localized mesenteric artery. Indapamide (n = 12) or placebo (n = 12) were given to 8-week-old rats for 4 weeks. After anesthesia and laparotomy, a segment of mesenteric artery (external diameter, 300-400 microns) was exposed for video-microscopic measurements. The diameter-pressure relationships were established under active conditions (phenylephrine, 10(-6) M) and passive conditions (potassium cyanide, KCN) for transmural pressure ranging from atmospheric pressure to 200 mm Hg. These studied arterial segments were then fixed and their wall cross-sectional areas (CSA) measured in transverse sections. Active wall stress and tension were defined as the differences in wall stresses and wall tensions calculated for active and passive conditions. Systolic arterial pressure and mesenteric CSA were decreased in treated rats (197 +/- 15 mm Hg vs. 211 +/- 12 mm Hg, p < 0.05; 16,230 +/- 1048 microns2 vs. 19,033 +/- 1082 microns2, p < 0.05). In both groups, mesenteric diameters were smaller under active than under passive conditions without significant differences in treated vs. untreated group under active conditions. The active wall tension was lower in treated (0.4 +/- 0.19 N/m) than in untreated rats (1.19 +/- 0.62 N/m, p < 0.05). However, there were no differences in active wall stress in both groups (103 +/- 47 kPa and 134 +/- 30 kPa).(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1993

Comparative effects of indapamide and hydrochlorothiazide on cardiac hypertrophy and vascular smooth-muscle phenotype in the stroke-prone, spontaneously hypertensive rat.

The effects of two diuretics, indapamide (3 mg/kg/day) and hydrochlorothiazide (20 mg/kg/day), were analyzed over a 44-day period on the cardiovascular hypertrophy of stroke-prone spontaneously hypertensive rats (SHR-SP). Untreated SHR-SP developed severe hypertension and cardiac hypertrophy when compared to normotensive Wistar-Kyoto (WKY) rats after 8 weeks on 1% sodium chloride. In diuretic-treated animals, systolic blood pressure was moderately decreased by the end of the treatment when compared with untreated SHR-SP (-13 and -18%, respectively, p < or = 0.05). Morphometric analysis of myocyte cross-sectional areas evidenced that indapamide was the most effective in preventing myocyte hypertrophy (-33%, p < or = 0.0001). Small coronary artery wall thickness was efficiently prevented in the two treated groups, but medial hypertrophy was prevented by hydrochlorothiazide only. Among markers of smooth-muscle cell phenotype (contractile or extracellular matrix proteins) EIIIA-fibronectin (FN), one FN cellular isoform, was shown to be the most sensitive marker by an immunohistochemical technic. Medial expression of EIIIA-FN, which was characteristic of SHR-SP coronary arteries, was prevented by the two treatments. The two diuretic treatments, despite similar effects on blood pressure and smooth-muscle phenotype, prevent SHR-SP cardiovascular hypertrophy with a drug-specific efficiency.

Animals↗
PubMedDate not supplied

Glucose and lipid metabolism during long-term antihypertensive treatment with indapamide in non-insulin-dependent diabetic patients.

Thirty-nine patients with diabetes and hypertension were treated with indapamide for 24 weeks to study the effects of that drug on glucose and lipid metabolism. The drug was administered at a dose of 2 mg once per day in the morning as a single drug (26 patients) or in combination with other antihypertensive drugs (13 patients), including calcium antagonists, angiotensin-converting enzyme inhibitors, an alpha-blocker, or a beta-blocker. Blood pressure was reduced in both groups during treatment, and no alteration of glycemic control or lipid metabolism was observed. One patient complained of a mild headache, but treatment was continued. The results indicate that indapamide is useful for the long-term treatment of hypertension in diabetic patients, either alone or in combination with other antihypertensive agents.

Aged↗
PubMed1977

[Antihypertensive effect of indapamide].

2.5 mg/day indapamide was administered to 16 hypertensive patients for 30 days. These was a gradual, significant reduction in systolic and diastolic pressure values with no significant changes in plasma and urinary electrolytes. The effect of the drug on ARP and renal performance was also examined. There were no alterations of other metabolic parameters. These data point to a safe and lasting hpotensive action on the part of indapamide.

Adult↗
PubMed1996

[Evaluation of trough/peak ratio of indapamide 1.5 mg sustained-release form assessed by ambulatory blood pressure monitoring].

Because of the high variability of casual blood pressure measurements. ABPM has become a complementary clinical tool for evaluating antihypertensive treatment. Nevertheless, there is still a lack of practical guidelines to interpret the data. A review of the literature shows that ABPM efficacy data are analyzed differently, especially the trough-to-peak ratio proposed by the Food and Drug Administration. Published trough-to-peak ratios are widely disparate due to the diversity of the calculation methods which are most often not justified. Thus inappropriate comparisons of these results can easily produce incorrect conclusions. The aim of this review is to select, through the literature, basic methodological requirements commonly agreed on for accurate assessment of trough-to-peak ratio, and to apply them to the ABPM data on indapamide, a diuretic related to the thiazides. Six methodological requirements commonly agreed on at this time are the following: 1. study design: placebo-controlled study with a placebo run-in period; 2. patients selection: compliance with the study protocol, record obtained before and after treatment for each patient; 3. population analysis: whole and responder population: 4. quality control of the records: 5. placebo effect subtraction; 6. global and individual calculation with the indication of median values. Given that, no T/P ratio, especially for a diuretic, has yet been calculated according to these requirements, the above methodological points were taken into account for the T/P calculation of indapamide, from a placebo-controlled dose-finding study involving 285 patients.

Adult↗
PubMedDate not supplied

Fixed drug eruption induced by indapamide. Cross-reactivity with sulfonamides.

Indapamide is a nontiazidic sulfonamide diuretic which has not been previously reported as a cause of fixed drug eruption. We describe a patient who experienced several episodes of fixed drug eruption during treatment with indapamide. The diagnosis was confirmed by positive controlled oral challenge test. The possible existence of cross-reactivity with other sulfonamide derivatives was investigated by controlled oral challenge test with sulfamethoxazole, sulfadiazine and furosemide, with the tests with sulfamethoxazole and sulfadiazine resulting positive.

Aged↗
PubMed1998

Protective effects of delapril, indapamide and their combination on stroke occurrence and lifespan in salt-loaded stroke-prone spontaneously hypertensive rats.

The effects of long-term oral administration of delapril (CAS 83435-67-0), indapamide (CAS 26807-65-8) and their combination on the occurrence of stroke and on mortality were investigated in young salt-loaded stroke-prone spontaneously hypertensive rats (SHRsp) for 31 weeks of treatment (8th-39th week of age) and up to 8 weeks thereafter. Body weight and saline consumption were investigated at regular intervals and cerebrovascular lesions, renal and heart weight were assessed after sacrifice. Untreated SHRsp served as controls. About 50% of control animals died within 6 weeks of saline administration and in 56% of surviving animals cerebral lesions were present at sacrifice, while no death and no cerebral lesions were observed in animals drinking saline, to which delapril, indapamide and their combination had been added, up to the end of treatment. This protective effect was maintained even in the withdrawal period. All treatments induced a highly significant (p < 0.001) reduction of heart weight/body weight and kidney weight/body weight ratios.

Angiotensin-Converting Enzyme Inhibitors↗
PubMed1996

Combination Treatment with Sustained-Release Verapamil and Indapamide in the Treatment of Mild-to-Moderate Hypertension.

A multicenter study of the treatment of mild and moderate hypertension compared three once-daily regimens for efficacy and safety: Group I, verapamil sustained release (SR) 240 mg; Group II, verapamil SR 480 mg; and Group III, verapamil SR 240 mg plus indapamide 2.5. mg. After a 3-week placebo washout period and a 2-week preliminary treatment period with verapamil SR 240 mg, patients with sitting diastolic blood pressures of 95--115 mm Hg were randomized in a double-blind fashion to one of the three treatment groups for a duration of 16 weeks. (Patients with diastolic BP < 95 mm Hg on this initial treatment were excluded from further study.) Efficacy assessed after 16 weeks or at the end point showed all three treatments significantly reduced sitting diastolic blood pressure from baseline levels. Compared with Group I (low-dose) verapamil SR treatment, there was a reduction in Group III combination therapy of 8.6 mm Hg systolic and 3.0 mm Hg diastolic and a significant reduction in Group II high-dose verapamil SR therapy of 7.6 mm Hg systolic and 3.9 mm Hg diastolic BP. Efficacy results were independent of age or body weight. Patients who were poor responders to lead-in verapamil SR 240 mg daily prior to randomization tended to have a greater response to combination therapy than to high-dose verapamil SR. Adverse experiences leading to withdrawal from the study occurred in 21% of patients receiving high-dose verapamil (Group II), exceeding the withdrawal from the other two treatment groups (8.5% from Group II and 4% from Group I). The most frequent adverse experiences in Group II were constipation and peripheral edema; headache was most common in Groups I and III. This trial demonstrates that adding indapamide to low-dose verapamil SR enhances efficacy and is well tolerated.

Journal Article↗