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 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.
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 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.
Authors: Giuseppe Mancia; Guy De Backer; Anna Dominiczak; Renata Cifkova; Robert Fagard; Giuseppe Germano; Guido Grassi; Anthony M Heagerty; Sverre E Kjeldsen; Stephane Laurent; Krzysztof Narkiewicz; Luis Ruilope; Andrzej Rynkiewicz; Roland E Schmieder; Harry Aj Struijker Boudier; Alberto Zanchetti Journal: J Hypertens Date: 2007-09 Impact factor: 4.844
Authors: Anushka Patel; S MacMahon; J Chalmers; B Neal; M Woodward; L Billot; S Harrap; N Poulter; M Marre; M Cooper; P Glasziou; D E Grobbee; P Hamet; S Heller; L S Liu; G Mancia; C E Mogensen; C Y Pan; A Rodgers; B Williams Journal: Lancet Date: 2007-09-08 Impact factor: 79.321
Authors: Nigel S Beckett; Ruth Peters; Astrid E Fletcher; Jan A Staessen; Lisheng Liu; Dan Dumitrascu; Vassil Stoyanovsky; Riitta L Antikainen; Yuri Nikitin; Craig Anderson; Alli Belhani; Françoise Forette; Chakravarthi Rajkumar; Lutgarde Thijs; Winston Banya; Christopher J Bulpitt Journal: N Engl J Med Date: 2008-03-31 Impact factor: 91.245
Authors: Maryam Afkarian; Michael C Sachs; Bryan Kestenbaum; Irl B Hirsch; Katherine R Tuttle; Jonathan Himmelfarb; Ian H de Boer Journal: J Am Soc Nephrol Date: 2013-01-29 Impact factor: 10.121
Authors: Giuseppe Mancia; Robert Fagard; Krzysztof Narkiewicz; Josep Redon; Alberto Zanchetti; Michael Böhm; Thierry Christiaens; Renata Cifkova; Guy De Backer; Anna Dominiczak; Maurizio Galderisi; Diederick E Grobbee; Tiny Jaarsma; Paulus Kirchhof; Sverre E Kjeldsen; Stéphane Laurent; Athanasios J Manolis; Peter M Nilsson; Luis Miguel Ruilope; Roland E Schmieder; Per Anton Sirnes; Peter Sleight; Margus Viigimaa; Bernard Waeber; Faiez Zannad; Josep Redon; Anna Dominiczak; Krzysztof Narkiewicz; Peter M Nilsson; Michel Burnier; Margus Viigimaa; Ettore Ambrosioni; Mark Caufield; Antonio Coca; Michael Hecht Olsen; Roland E Schmieder; Costas Tsioufis; Philippe van de Borne; Jose Luis Zamorano; Stephan Achenbach; Helmut Baumgartner; Jeroen J Bax; Héctor Bueno; Veronica Dean; Christi Deaton; Cetin Erol; Robert Fagard; Roberto Ferrari; David Hasdai; Arno W Hoes; Paulus Kirchhof; Juhani Knuuti; Philippe Kolh; Patrizio Lancellotti; Ales Linhart; Petros Nihoyannopoulos; Massimo F Piepoli; Piotr Ponikowski; Per Anton Sirnes; Juan Luis Tamargo; Michal Tendera; Adam Torbicki; William Wijns; Stephan Windecker; Denis L Clement; Antonio Coca; Thierry C Gillebert; Michal Tendera; Enrico Agabiti Rosei; Ettore Ambrosioni; Stefan D Anker; Johann Bauersachs; Jana Brguljan Hitij; Mark Caulfield; Marc De Buyzere; Sabina De Geest; Geneviève Anne Derumeaux; Serap Erdine; Csaba Farsang; Christian Funck-Brentano; Vjekoslav Gerc; Giuseppe Germano; Stephan Gielen; Herman Haller; Arno W Hoes; Jens Jordan; Thomas Kahan; Michel Komajda; Dragan Lovic; Heiko Mahrholdt; Michael Hecht Olsen; Jan Ostergren; Gianfranco Parati; Joep Perk; Jorge Polonia; Bogdan A Popescu; Zeljko Reiner; Lars Rydén; Yuriy Sirenko; Alice Stanton; Harry Struijker-Boudier; Costas Tsioufis; Philippe van de Borne; Charalambos Vlachopoulos; Massimo Volpe; David A Wood Journal: Eur Heart J Date: 2013-06-14 Impact factor: 29.983