Kuo Shi-Wen, Hung Yi-Jen, Hsieh An-Tsz, Wu Ling-Yi, Hsieh Chang-Hsun, He Chih-Tsueng, Yang Tsao-Chin, Lian Wei-Cheng
Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, No. 325 Cheng-kung Road, Section 2, Neihu 114, Taipei, Taiwan, R.O.C.
Am J Hypertens. 2003 Aug;16(8):623-8. doi: 10.1016/s0895-7061(03)00896-3.
To evaluate the effect of the sustained-release formulation of indapamide (indapamide SR) in type 2 diabetic patients with mild-to-moderate hypertension and its possible side effects, particularly on glucose metabolism and lipid profiles.
A total of 64 patients randomly received 1.5 mg of indapamide SR or placebo once daily for 3 months. The effects were evaluated by 24-h ambulatory blood pressure monitor, fasting blood sampling for biochemistry, lipid profiles, and frequently sampled intravenous glucose tolerance test.
The changes in standing and supine blood pressure (BP) were significant (154.7 +/- 9.4/94 +/- 2.9 mm Hg v 134.4 +/- 5.1/82.4 +/- 5 mm Hg and 155 +/- 9.8/94.6 +/- 3.6 mm Hg v 135.1 +/- 4.9/82.1 +/- 4.7 mm Hg) in the indapamide group, but not in the placebo group. According to the 24-h ambulatory blood pressure monitor reading, a significant reduction was observed in not only in the whole-day mean BP (mean systolic BP/mean diastolic BP, 149 +/- 19.3/87.6 +/- 11.3 mm Hg v 135.7 +/- 12.6/79.6 +/- 9 mm Hg) but also the whole-day mean median arterial pressure (109 +/- 12.7 mm Hg v 98.7 +/- 8.2 mm Hg) for the indapamide group, but not the placebo group. There were no changes in biochemical data including serum sodium, potassium, chloride, uric acid, alanine aminotransferase, aspartate aminotransferase, blood urea nitrogen, creatinine, lipid profiles, fasting blood glucose, insulin, hemoglobin Alc, and glucose metabolism parameters (insulin sensitivity, glucose effectiveness, and acute insulin response) from frequently sampled intravenous glucose tolerance test after indapamide or placebo therapy.
Indapamide SR can significantly lower the whole-day BP in hypertensive patients with type 2 diabetes. Also, it did not alter or aggravate patients' lipid profiles, glucose metabolism, and did not exert possible side effects of hypokalemia and hyperuricemia. Therefore, monotherapy with indapamide SR should be suggested in type 2 diabetic patients with mild-to-moderate hypertension.
评估吲达帕胺缓释制剂（吲达帕胺SR）对2型糖尿病合并轻至中度高血压患者的疗效及其可能的副作用，尤其是对糖代谢和血脂谱的影响。
64例患者随机接受每日1.5 mg吲达帕胺SR或安慰剂治疗，为期3个月。通过24小时动态血压监测、空腹血样生化检测、血脂谱检测以及频繁取样静脉葡萄糖耐量试验评估疗效。
吲达帕胺组站立位和仰卧位血压变化显著（154.7±9.4/94±2.9 mmHg对134.4±5.1/82.4±5 mmHg以及155±9.8/94.6±3.6 mmHg对135.1±4.9/82.1±4.7 mmHg），而安慰剂组无变化。根据24小时动态血压监测读数，吲达帕胺组不仅全天平均血压（平均收缩压/平均舒张压，149±19.3/87.6±11.3 mmHg对135.7±12.6/79.6±9 mmHg）显著降低，全天平均动脉压（109±12.7 mmHg对98.7±8.2 mmHg）也显著降低，安慰剂组则无此变化。吲达帕胺或安慰剂治疗后，包括血清钠、钾、氯、尿酸、丙氨酸转氨酶、天冬氨酸转氨酶、血尿素氮、肌酐、血脂谱、空腹血糖、胰岛素、糖化血红蛋白以及频繁取样静脉葡萄糖耐量试验的糖代谢参数（胰岛素敏感性、葡萄糖效能和急性胰岛素反应）等生化数据均无变化。
吲达帕胺SR可显著降低2型糖尿病高血压患者的全天血压。此外，它不会改变或加重患者的血脂谱、糖代谢，也不会产生低钾血症和高尿酸血症等可能的副作用。因此，对于2型糖尿病合并轻至中度高血压患者，建议使用吲达帕胺SR进行单药治疗。
