The treatment of hypertension with indapamide alone or in combination with other drugs.

Twenty-six patients (average age 50 years) with essential hypertension were treated for 4 months with 2.5 mg indapamide per day, alone or in combination with other drugs. Before treatment, the average blood pressure was 208/128 mmHg, and each patient had undergone at least 6-months' therapy with hydrochlorothiazide alone (6 patients), in combination with reserpine (11 patients), or with methyldopa, hydralazine, propranolol, metoprolol or guanethidine (9 patients). Indapamide was prescribed to replace hydrochlorothiazide, the other antihypertensive drugs being continued in those patients receiving combination therapy. The average supine blood pressure decreased from 148/93 mmHg with hydrochlorothiazide to 143/92 mmHg during an intermediate 4-week placebo period, and to 135/86 mmHg with indapamide. Effects on blood pressure and all other parameters were the same, whether indapamide was used alone or in combination with other drugs. Serum potassium levels at the end of treatment averaged 3.6 mmol/l, a value similar to that obtained with hydrochlorothiazide. Plasma bicarbonate was unchanged (27.5 mmol/l), serum uric acid averaged 7.4 mg/dl, and renal function remained normal. Other parameters showing no change included blood glucose, cholesterol, triglycerides, total bilirubin, transaminases, platelets, etc. All the patients reported a sensation of well-being during treatment with indapamide; this drug shows clinical and biochemical effects similar to those of the thiazide-type diuretics.