Effect of antihypertensive treatment on the prevalence of ventricular arrhythmias among patients with isolated systolic hypertension without left ventricular hypertrophy
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Indapamide
Perindopril
Most patients with hypertension will need, at some stage, more than one drug to lower their blood pressure. Although monotherapy is still the preferred option for first-line treatment of hypertension, low-dose combination therapy as the initial medication has been increasingly recommended by National and International Guidelines. The use of perindopril/indapamide is an example of such a combination which contains 2 mg of the angiotensin converting enzyme inhibitor perindopril and 0.625 mg of the diuretic indapamide, these doses being respectively half and a quarter of the usual doses in monotherapy. This combination appears to lower blood pressure effectively with a good safety profile. It can be used in the elderly and also in patients with reduced renal function. Studies are underway to assess its efficacy on target organ damage.
Indapamide
Perindopril
Combination therapy
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(1) The combination of perindopril 4 mg + indapamide 1.25 mg is approved for second-line treatment of hypertension after failure of perindopril alone. (2) The other combination, of a low dose of an angiotensin-converting-enzyme inhibitor (2 mg of perindopril) and a diuretic (0.625 mg of indapamide), is being promoted as first-line treatment of hypertension. (3) The clinical files for both preparations are limited to the strict minimum. (4) A dose-finding study showed that the perindopril 4 mg + indapamide 1.25 mg dose combination offered the best risk-benefit ratio by comparison with combinations containing the same perindopril dose but other indapamide doses. (5) A double-blind trial suggests that the antihypertensive activity of the perindopril 4 mg + indapamide 1.25 mg combination is equivalent to that of the captopril 50 mg + hydrochlorothiazide 25 mg and enalapril 20 mg + hydrochlorothiazide 12.5 mg combinations. The safety profile was the same for the three combinations. (6) The 2-mg perindopril combination has not been compared with perindopril monotherapy at the usual dose of 4 mg, or with indapamide monotherapy at a mean dose of 2.5 mg. (7) The two combinations are costlier than their competitors.
Indapamide
Perindopril
Captopril
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The antihypertensive effects and tolerance of a fixed low-dose combination of the angiotensin-converting enzyme (ACE) inhibitor perindopril (2 mg) and the diuretic indapamide (0.625 mg) were studied in patients with mild and moderate arterial hypertension. The patients' mean age was 51.35 +/- 5.02 years. The antihypertensive effects were evaluated from the results of daily blood pressure monitoring following 12 weeks of therapy. It was found that low-dose combination of perindopril and the indapamide exerted a multidirectional corrective effect on the daily blood pressure (BP): it provided a significant optimal BP lowering during a day on a long-term basis and significantly diminished the baseline increased systolic and diastolic BP variability during a day.
Indapamide
Perindopril
Pharmacotherapy
Essential hypertension
Fixed-dose combination
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Objective. The aim of the study was to compare the antihypertensive efficacy of fixed combinations of perindopril and indapamide in patients with arterial hypertension (HTN) and high cardiovascular risk. Design and methods. We included 65 patients with 1–2 degree of HTN who had not taken the studied drugs before: either perindopril arginine / indapamide 10 mg + 2,5 mg, n = 35), or indapamide / perindopril erbumine K 2,5 mg + 8 mg, n = 30). Clinical efficacy of antihypertensive therapy was evaluated at three different time points. We assessed objective clinical status, blood biochemistry, office blood pressure (BP), and parameters of daily monitoring of BP (MBP). Results. Perindopril arginine plus indapamide vs indapamide plus perindopril erbumine K after 4 and after 12 weeks shows higher antihypertensive effect regarding office BP and provides significantly better control of the daily BP profile based on the MBP results. Therefore, MBP is required in HTN high-risk patients who take indapamide / perindopril erbuminе K in order to assess the reduction in nighttime BP, independently of achieving target office BP values.
Indapamide
Perindopril
Essential hypertension
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Indapamide
Perindopril
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PROGRESS (Perindopril pROtection aGainst REcurrent Stroke Study) was an international multicentre trial designed primarily to determine the effects of lowering blood pressure on the risk of recurrent strokes, using perindopril alone or with indapamide, in hypertensive and normotensive patients with and without diabetes. Treatment with perindopril ± indapamide for four years reduced the risk of a further stroke by 28% and cerebral haemorrhage by 50%.
Indapamide
Perindopril
Stroke
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The persistence of the antihypertensive effect of perindopril 2 mg+indapamide 0.625 mg once daily for up to 72 h was evaluated using the “missed‐dose” technique. After 4 weeks on perindopril 2 mg+indapamide 0.625 mg, 79 of 216 hypertensive patients at goal (diastolic blood pressure <85 mmHg) continued on perindopril 2 mg+indapamide 0.625 mg for a further 8 weeks. During either week 9 or 11, placebo was substituted for perindopril 2 mg+indapamide 0.625 mg on either 1 day or on 2 consecutive days. Twenty‐four‐hour ambulatory blood pressure was recorded at baseline, after 9 or 11 weeks of perindopril 2 mg+indapamide 0.625 mg and during the simulated missed doses, 24–48 and 48–72 h after perindopril 2 mg+indapamide 0.625 mg. Significant (p<0.001) reductions in mean (±SD) 24‐h blood pressure (mmHg) during the first 24 h after perindopril 2 mg+indapamide 0.625 mg vs baseline were noted for the two sub‐groups subsequently allocated to one missed dose (−13.5±10.4/−8.0±6.6) or two missed doses (−12.2±7.4/−6.9±4.2). The antihypertensive effect persisted (p<0.001 to p<0.05 vs baseline) on the days when placebo was substituted for perindopril 2 mg+indapamide 0.625 mg with reductions in mean 24‐h blood pressure from 24–48 h and 48–72 h after dosing being −11.6±9.6/−6.3±6.4 and −6.4±6.0/−3.9±4.2, respectively. Use of the “missed‐dose” technique demonstrated persistence of an antihypertensive effect for perindopril 2 mg+indapamide 0.625 mg for up to 72 h after dosing.
Indapamide
Perindopril
Essential hypertension
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Objective:To investigate the hypotensive effect and adverse reactions of Perindopril combined with Indapamide in primary hypertension.Methods:From July 2009 to December 2009 in our department,90 patients diagnosed with essential hypertension were randomized groups,46 cases of treatment group and 44 cases of control group,they were excluded secondary hypertension.These patients stopped taking antihypertensive drugs more than 5 days.Before and after treatment,the blood and urine routine,ECG and blood lipids,blood glucose,liver and kidney function were recorded.The control group treated with Indapamide 2.5 mg/d or 5 mg/d;the treatment group treated with Indapamide 2.5 mg/d and Perindopril 4 mg/d;the curative effect were assessed after 8 weeks.Results:The total effective rate of treatment group was 87.0%,and the control group was 59.1%,the difference was statistically significant(P0.05),and the treatment group had less adverse reactions.Conclusion:Perindopril combined with Indapamide in the treatment of primary hypertension has good effect and less adverse reactions,it is worth popularizing.
Indapamide
Perindopril
Essential hypertension
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PROGRESS ("Perindopril pROtection aGainst REcurrent Stroke Study") demonstrated that blood-pressure lowering treatment with perindopril, an angiotensin converting enzyme inhibitor (combined with the diuretic agent indapamide when necessary), reduces the risk of stroke by 28% (95% CI: 17-38, p < 0.0001) among patients with a history of stroke or transient ischaemic attack. This protective effect was observed among both hypertensive and non-hypertensive individuals. It was more marked in the patients receiving combined perindopril + indapamide treatment (-43%; 95% CI 30-54) who were those who showed the greatest reduction in arterial blood pressure (-12/5 mm Hg). According to these observations, the authors concluded that treatment with these two agents should now be considered routinely for patients with a history of stroke or transient ischaemic attack, irrespective of their blood pressure.
Indapamide
Perindopril
Stroke
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