Asmar R
Service de Médecine Interne, Hôpital Broussais, Paris, France.
Ann Cardiol Angeiol (Paris). 1998 Feb;47(2):94-104.
In line with international recommendations concerning the need to decrease the doses of antihypertensives, a low dose form (1.5 mg) of indapamide, sustained release coated tablet (SR), has been developed in order to optimize the efficacy-safety ratio while maintaining a once daily dosage. The objective of this study was to evaluate the benefit obtained by reviewing the results of two clinical trials conducted according to a similar methodology.
European randomized double-blind trials were conducted in a total of 690 hypertensive patients. The first trial was conducted in 285 patients treated for 2 months and the second trial was conducted in 405 patients treated for 3 months. The second study was extended to 9 months under open-label conditions in order to obtain a follow-up of one year with clinical and ambulatory blood pressure monitoring. The average patient characteristics on inclusion were, in the two studies: age: 53 and 57 years, 44% and 57% of men, diastolic blood pressure (DRP): 100.6 and 102.5 mmHg, systolic blood pressure (SBP): 161.0 and 164.5 mmHg.
The first dose-ranging study demonstrated the antihypertensive efficacy of indapamide 1.5 mg SR; the study second confirmed the equivalent efficacy with the 2.5 mg immediate release form of indapamide and a greater than 50% reduction of the number of patients presenting a serum potassium less than 3.4 mmol/l. The long-term study verified the absence of therapeutic escape. Clinical safety data assessed the absence of effects of indapamide on carbohydrate and lipid metabolism.
Indapamide 1.5 mg sustained release coated tablet presents an optimized antihypertensive efficacy/safety ratio in line with international recommendations concerning the use of low-dose antihypertensives and diuretics as first-line treatment for hypertension.
根据国际上关于降低抗高血压药物剂量的建议,已研发出一种低剂量(1.5毫克)的吲达帕胺缓释包衣片(SR),以优化疗效-安全性比,同时保持每日一次给药。本研究的目的是通过回顾两项采用相似方法进行的临床试验结果来评估所获得的益处。
在总共690名高血压患者中开展了欧洲随机双盲试验。第一项试验纳入285名患者,治疗2个月;第二项试验纳入405名患者,治疗3个月。第二项研究在开放标签条件下延长至9个月,以便通过临床和动态血压监测获得一年的随访结果。在这两项研究中,纳入时患者的平均特征如下:年龄分别为53岁和57岁,男性分别占44%和57%,舒张压(DBP)分别为100.6和102.5毫米汞柱,收缩压(SBP)分别为161.0和164.5毫米汞柱。
第一项剂量范围研究证明了吲达帕胺1.5毫克SR的抗高血压疗效;第二项研究证实其与吲达帕胺2.5毫克速释剂型疗效相当,且血清钾低于3.4毫摩尔/升的患者数量减少了50%以上。长期研究证实不存在治疗失效情况。临床安全性数据评估显示吲达帕胺对碳水化合物和脂质代谢无影响。
吲达帕胺1.5毫克缓释包衣片呈现出优化的抗高血压疗效/安全性比,符合国际上关于使用低剂量抗高血压药物和利尿剂作为高血压一线治疗的建议。