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Fixed combination of perindopril and indapamide at low dose improves endothelial function in essential hypertensive patients after acute administration.
Am J Hypertens 2008; 21(6):679-84AJ

Abstract

BACKGROUND

Fixed combination of angiotensin-converting enzyme inhibitors (ACEIs) with thiazide-type diuretics at low dose has been used as first-line therapy for the treatment of essential hypertension but their effect on conduit artery endothelial dysfunction remains unknown.

METHODS

Thirteen hypertensive patients were assessed after acute administration of a placebo, fixed combination of perindopril-indapamide at low dose: D1 (2 mg/0.625 mg) and twice this dose: D2 (4 mg/1.25 mg), during a double-blind, randomized, crossover study, and were compared with 13 matched controls. Mean arterial pressure (MAP), radial artery diameter (echotracking) and flow (Doppler) were measured during flow-mediated dilatation (FMD) induced by post-ischemic hyperemia (PIH). PIH was characterized by peak flow and duration of hyperemia (t(1/2)). Endothelium-independent dilatation was assessed by trinitrine.

RESULTS

In hypertensive patients compared with controls, basal radial artery diameter and flow, peak flow, and trinitrine responses were similar while MAP was increased (115 +/- 3 vs. 87 +/- 2 mm Hg), t(1/2) was decreased (11.1 +/- 1.9 vs. 17.2 +/- 2.2 s), and FMD was altered (radial diameter increase: 203 +/- 14 vs. 304 +/- 15 microm). Compared with placebo, only D2 decreased MAP (placebo: 115 +/- 3; D1: 112 +/- 4; D2: 103 +/- 4 mm Hg) and increased t(1/2) (placebo: 11.1 +/- 1.9; D1: 8.7 +/- 1.5; D2:13.0 +/- 1.9 s). Conversely, D1 and D2 increased FMD (placebo: 203 +/- 14; D1: 218 +/- 22; D2: 227 +/- 23 microm) with no change in basal diameter and flow, peak flow, and trinitrine responses.

CONCLUSION

These results demonstrate that a fixed combination of ACEI/diuretic at low dose significantly improves radial artery FMD in hypertensive patients and suggest a direct effect on conduit artery endothelium that may contribute to vascular protection.

Authors+Show Affiliations

Department of Pharmacology, Rouen University Hospital & INSERM U644 (IFRMP 23), Institute for Biomedical Research, University of Rouen, Rouen Cedex, France. robinson.joannides@chu-rouen.frNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

18443573

Citation

Joannides, Robinson, et al. "Fixed Combination of Perindopril and Indapamide at Low Dose Improves Endothelial Function in Essential Hypertensive Patients After Acute Administration." American Journal of Hypertension, vol. 21, no. 6, 2008, pp. 679-84.
Joannides R, Bellien J, Thurlure C, et al. Fixed combination of perindopril and indapamide at low dose improves endothelial function in essential hypertensive patients after acute administration. Am J Hypertens. 2008;21(6):679-84.
Joannides, R., Bellien, J., Thurlure, C., Iacob, M., Abeel, M., & Thuillez, C. (2008). Fixed combination of perindopril and indapamide at low dose improves endothelial function in essential hypertensive patients after acute administration. American Journal of Hypertension, 21(6), pp. 679-84. doi:10.1038/ajh.2008.39.
Joannides R, et al. Fixed Combination of Perindopril and Indapamide at Low Dose Improves Endothelial Function in Essential Hypertensive Patients After Acute Administration. Am J Hypertens. 2008;21(6):679-84. PubMed PMID: 18443573.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Fixed combination of perindopril and indapamide at low dose improves endothelial function in essential hypertensive patients after acute administration. AU - Joannides,Robinson, AU - Bellien,Jeremy, AU - Thurlure,Celine, AU - Iacob,Michele, AU - Abeel,Murielle, AU - Thuillez,Christian, Y1 - 2008/04/03/ PY - 2008/4/30/pubmed PY - 2008/10/3/medline PY - 2008/4/30/entrez SP - 679 EP - 84 JF - American journal of hypertension JO - Am. J. Hypertens. VL - 21 IS - 6 N2 - BACKGROUND: Fixed combination of angiotensin-converting enzyme inhibitors (ACEIs) with thiazide-type diuretics at low dose has been used as first-line therapy for the treatment of essential hypertension but their effect on conduit artery endothelial dysfunction remains unknown. METHODS: Thirteen hypertensive patients were assessed after acute administration of a placebo, fixed combination of perindopril-indapamide at low dose: D1 (2 mg/0.625 mg) and twice this dose: D2 (4 mg/1.25 mg), during a double-blind, randomized, crossover study, and were compared with 13 matched controls. Mean arterial pressure (MAP), radial artery diameter (echotracking) and flow (Doppler) were measured during flow-mediated dilatation (FMD) induced by post-ischemic hyperemia (PIH). PIH was characterized by peak flow and duration of hyperemia (t(1/2)). Endothelium-independent dilatation was assessed by trinitrine. RESULTS: In hypertensive patients compared with controls, basal radial artery diameter and flow, peak flow, and trinitrine responses were similar while MAP was increased (115 +/- 3 vs. 87 +/- 2 mm Hg), t(1/2) was decreased (11.1 +/- 1.9 vs. 17.2 +/- 2.2 s), and FMD was altered (radial diameter increase: 203 +/- 14 vs. 304 +/- 15 microm). Compared with placebo, only D2 decreased MAP (placebo: 115 +/- 3; D1: 112 +/- 4; D2: 103 +/- 4 mm Hg) and increased t(1/2) (placebo: 11.1 +/- 1.9; D1: 8.7 +/- 1.5; D2:13.0 +/- 1.9 s). Conversely, D1 and D2 increased FMD (placebo: 203 +/- 14; D1: 218 +/- 22; D2: 227 +/- 23 microm) with no change in basal diameter and flow, peak flow, and trinitrine responses. CONCLUSION: These results demonstrate that a fixed combination of ACEI/diuretic at low dose significantly improves radial artery FMD in hypertensive patients and suggest a direct effect on conduit artery endothelium that may contribute to vascular protection. SN - 0895-7061 UR - https://www.unboundmedicine.com/medline/citation/18443573/Fixed_combination_of_perindopril_and_indapamide_at_low_dose_improves_endothelial_function_in_essential_hypertensive_patients_after_acute_administration_ L2 - https://academic.oup.com/ajh/article-lookup/doi/10.1038/ajh.2008.39 DB - PRIME DP - Unbound Medicine ER -