Efficacy of Single-Pill Perindopril/Indapamide in Patients with Hypertension and Type 2 Diabetes
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ORIGINAL ARTICLE
Efficacy of Single-Pill Perindopril/Indapamide in Patients with Hypertension and Type 2 Diabetes T. A. Netchessova • A. P. Shepelkevich • T. V. Gorbat • on behalf of the NIKA Study Group
Received: 9 October 2013 / Accepted: 4 December 2013 Ó Springer International Publishing Switzerland 2013
Abstract Objective Hypertension and type 2 diabetes in combination are associated with a significantly higher level of cardiovascular events. The aim of this prospective study was to evaluate the antihypertensive efficacy and tolerability of single-pill perindopril/indapamide in patients with hypertension and type 2 diabetes. Design and Methods Patients with both hypertension and type 2 diabetes were enrolled in this multicenter, prospective, open clinical study. Single-pill perindopril/ indapamide was either prescribed on its own (started or switched to from previous treatment) or added to previous therapy. Perindopril/indapamide dosage could be increased, from 5/1.25 mg to 10/2.5 mg once daily, if blood pressure (BP) was uncontrolled. BP and tolerability were assessed at 4 visits over a 6-month period. Microalbuminuria was assessed at baseline and 6 months in a subgroup. Results 397 patients were analyzed (age 57.6 ± 9.4 years, men 46 %). At baseline, systolic blood pressure (SBP) was 160.0 ± 14.3 mmHg, diastolic blood pressure (DBP) 95.2 ± 8.3 mmHg, and pulse pressure 64.8 ± 12.7 mmHg. Nearly half (45 %) of patients received perindopril/indapamide alone and 55 % added this single-pill combination to existing therapy. After 6 months, SBP fell by 30 mmHg, DBP by 14 mmHg, and pulse pressure by 16 mmHg (all p \ 0.0001). SBP was
T. A. Netchessova (&) T. V. Gorbat Republican Scientific Practical Center ‘‘Cardiology’’, R. Luxembourg str. 110, Minsk, Belarus e-mail: [email protected] A. P. Shepelkevich Belarusian State Medical University, Minsk, Belarus
normalized (\140 mmHg) in 84 % of patients who took perindopril/indapamide 5/1.25 mg alone and in 90 % of patients who took perindopril/indapamide 10/2.5 mg alone. Tolerability was rated ‘‘good’’ or ‘‘better’’ by nearly all (99 %) patients. In a microalbuminuria subgroup (n = 59; baseline microalbuminuria 20–200 mg/L; average age 60.5 ± 11.5 years; 28 men [47 %]), there was a significant decrease in SBP (from 160.5 ± 13.9 mmHg to 132.6 ± 12.0 mmHg) and DBP (from 95.3 ± 7.8 mmHg to 81.6 ± 8.4 mmHg) (p \ 0.001). Target SBP was reached by 71 % of these patients. Microalbuminuria decreased in 75 % of the subgroup during the follow-up period; levels fell significantly from 45 mg/L (30–88 mg/L) to 30 mg/L (20–50 mg/L) (p \ 0.0001). Conclusion Treatment with single-pill perindopril/indapamide 5/1.25 or 10/2.5 mg significantly reduced BP, improved BP control, and enhanced kidney protection in patients with hypertension and type 2 diabetes in everyday clinical practice. Keywords Perindopril Indapamide Hypertension Type 2 diabetes Microalbuminuria Nephroprotection
1 Introduction The combination of arterial hypertension and type 2 diabetes is the main reason fo
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