Effects of a Low Dose of Indapamide, a Diuretic, Given Daily or Every-Other-Day on Blood Pressure and Metabolic Parameters

To investigate the effects of the diuretic, indapamide, on blood pressure (BP) and metabolic parameters, thirty hypertensive patients were treated with 1 mg of indapamide either every day or every other day. BP, fasting plasma glucose, lipids, serum potassium and uric acid were determined at baseline and after 3 months of a stable regimen of the drug. At the termination of the study, 48-h ambulatory blood pressure monitoring (ABPM) was performed. Three patients received only indapamide, while other patients were treated in combination with additional antihypertensive medications. Patients treated with daily indapamide showed a BP reduction from 162±2.9/85±2.4 mmHg to 134±2.4/71±2.6 mmHg (p <0.001). The BP reduction was similar in those patients receiving the drug every other day (137±3.4/71±3.6 mmHg). While plasma lipids and serum potassium did not differ significantly with the intervention, uric acid increased significantly with daily treatment and normalized with every-other-day treatment. Glycosylated hemoglobin A1c (HbA1c) was not altered (5.6±0.1% vs. 5.4±0.2%), and did not differ between patients with and without diabetes mellitus. ABPM revealed an average 24-h BP of 134±3.3/75±1.7 mmHg on days in which patients received the medication and 139±4.9/78±2.6 mmHg on the intervening day without indapamide (no significant difference). These results suggest that a low dose of indapamide given every day or every other day is effective in lowering BP and does not result in metabolic derangements. (Hypertens Res 2004; 27: 141-145)