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Ambulatory blood pressure in hypertensive patients with left ventricular hypertrophy: efficacy of first-line combination perindopril/indapamide therapy.

Asmar R, Garcia-Puig J, Gosse P, Karpov YA, De Leeuws PW, Magometschniggs D, Matos L, Schmieder R - Vasc Health Risk Manag (2007)

Bottom Line: At study end, both treatments significantly improved ambulatory BP compared with baseline (p < or = 0.01).No unusual safety elements were noted.First-line perindopril/indapamide combination decreased ambulatory SBP and PP, and LVM more effectively than enalapril.

View Article: PubMed Central - PubMed

Affiliation: Institut Cardiovasculaire, Paris, France.

ABSTRACT

Background: Ambulatory blood pressure (BP) is more sensitive than office BP and is highly correlated with the left ventricular mass (LVM) of hypertensive patients with left ventricular hypertrophy (LVH).

Methods: In this prospectively designed ancillary study of the PICXEL trial, the effects of first-line combination perindopril/indapamide on ambulatory BP were compared with those of monotherapy with enalapril in 127 patients. Hypertensive patients with LVH received once daily either perindopril 2 mg/indapamide 0.625 mg (n = 65) or enalapril 10 mg (n = 62) for 52 weeks. Dose adjustments were allowed for uncontrolled BP. Twenty-four-hour ambulatory BP and echocardiographic parameters were measured at baseline, week 24, and week 52.

Results: At study end, both treatments significantly improved ambulatory BP compared with baseline (p < or = 0.01). Perindopril/indapamide treatment reduced 24-hour and daytime systolic BP (SBP) and pulse pressure (PP) significantly more than enalapril treatment (p < 0.01). No significant between-group differences were noted for diastolic BP (DBP) or for night-time measurements. Trough/peak ratios were higher with perindopril/indapamide than with enalapril (88.5 vs 65.8 for SBP and 86.7 vs 63.9 for DBP, respectively). The global smoothness index was higher with perindopril/indapamide than with enalapril (6.6 vs 5.2 for SBP and 5.6 vs 4.9 for DBP, respectively). With perindopril/indapamide treatment, LVM index was significantly reduced (-9.1 g/m2 from baseline; p vs baseline <0.001). More patients required dose increases with enalapril (87%) than with perindopril/indapamide (71%). No unusual safety elements were noted.

Conclusions: First-line perindopril/indapamide combination decreased ambulatory SBP and PP, and LVM more effectively than enalapril.

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Related in: MedlinePlus

Variations in blood pressure over 24 hours in perindopril/indapamide (n = 65) and enalapril (n = 62). A. SBP; B. DBP; C. PP. Mean baseline and end-of-study ambulatory blood pressure calculated every 2 hours are plotted.Abbreviations: DBP, diastolic blood pressure; PP, pulse pressure; SBP, systolic blood pressure.
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fig2: Variations in blood pressure over 24 hours in perindopril/indapamide (n = 65) and enalapril (n = 62). A. SBP; B. DBP; C. PP. Mean baseline and end-of-study ambulatory blood pressure calculated every 2 hours are plotted.Abbreviations: DBP, diastolic blood pressure; PP, pulse pressure; SBP, systolic blood pressure.

Mentions: At baseline, circadian variations of SBP, DBP, and PP, averaged every 2 hours over the 24-hour period, were similar for both groups. At study end, the circadian variation chronograms of SBP, DBP, and PP were lower in the perindopril/indapamide group than in the enalapril group throughout the 24-hour period (Figure 2).


Ambulatory blood pressure in hypertensive patients with left ventricular hypertrophy: efficacy of first-line combination perindopril/indapamide therapy.

Asmar R, Garcia-Puig J, Gosse P, Karpov YA, De Leeuws PW, Magometschniggs D, Matos L, Schmieder R - Vasc Health Risk Manag (2007)

Variations in blood pressure over 24 hours in perindopril/indapamide (n = 65) and enalapril (n = 62). A. SBP; B. DBP; C. PP. Mean baseline and end-of-study ambulatory blood pressure calculated every 2 hours are plotted.Abbreviations: DBP, diastolic blood pressure; PP, pulse pressure; SBP, systolic blood pressure.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC2291338&req=5

fig2: Variations in blood pressure over 24 hours in perindopril/indapamide (n = 65) and enalapril (n = 62). A. SBP; B. DBP; C. PP. Mean baseline and end-of-study ambulatory blood pressure calculated every 2 hours are plotted.Abbreviations: DBP, diastolic blood pressure; PP, pulse pressure; SBP, systolic blood pressure.
Mentions: At baseline, circadian variations of SBP, DBP, and PP, averaged every 2 hours over the 24-hour period, were similar for both groups. At study end, the circadian variation chronograms of SBP, DBP, and PP were lower in the perindopril/indapamide group than in the enalapril group throughout the 24-hour period (Figure 2).

Bottom Line: At study end, both treatments significantly improved ambulatory BP compared with baseline (p < or = 0.01).No unusual safety elements were noted.First-line perindopril/indapamide combination decreased ambulatory SBP and PP, and LVM more effectively than enalapril.

View Article: PubMed Central - PubMed

Affiliation: Institut Cardiovasculaire, Paris, France.

ABSTRACT

Background: Ambulatory blood pressure (BP) is more sensitive than office BP and is highly correlated with the left ventricular mass (LVM) of hypertensive patients with left ventricular hypertrophy (LVH).

Methods: In this prospectively designed ancillary study of the PICXEL trial, the effects of first-line combination perindopril/indapamide on ambulatory BP were compared with those of monotherapy with enalapril in 127 patients. Hypertensive patients with LVH received once daily either perindopril 2 mg/indapamide 0.625 mg (n = 65) or enalapril 10 mg (n = 62) for 52 weeks. Dose adjustments were allowed for uncontrolled BP. Twenty-four-hour ambulatory BP and echocardiographic parameters were measured at baseline, week 24, and week 52.

Results: At study end, both treatments significantly improved ambulatory BP compared with baseline (p < or = 0.01). Perindopril/indapamide treatment reduced 24-hour and daytime systolic BP (SBP) and pulse pressure (PP) significantly more than enalapril treatment (p < 0.01). No significant between-group differences were noted for diastolic BP (DBP) or for night-time measurements. Trough/peak ratios were higher with perindopril/indapamide than with enalapril (88.5 vs 65.8 for SBP and 86.7 vs 63.9 for DBP, respectively). The global smoothness index was higher with perindopril/indapamide than with enalapril (6.6 vs 5.2 for SBP and 5.6 vs 4.9 for DBP, respectively). With perindopril/indapamide treatment, LVM index was significantly reduced (-9.1 g/m2 from baseline; p vs baseline <0.001). More patients required dose increases with enalapril (87%) than with perindopril/indapamide (71%). No unusual safety elements were noted.

Conclusions: First-line perindopril/indapamide combination decreased ambulatory SBP and PP, and LVM more effectively than enalapril.

Show MeSH
Related in: MedlinePlus