Influence of fixed combination perindopril and indapamide on heart and vascular remodeling in hypertensive patients

Abstract

Aim. To evaluate antihypertensive efficacy of fixed combination: perindopril 4 mg/d plus indapamide 1.25 mg/d, and its influence on cardiovascular remodeling in untreated hypertensive patients.
Material and methods. The study included 25 previously untreated patients with arterial hypertension (mean age 48.1±2,7 years; 13 males, 12 females). The effects of 6-month perindopril/indapamide combined therapy on daily blood pressure (BP), left ventricular (LV) hypertrophy, carotid intima-media thickness (IMT), pulse wave velocity (PWV), and cerebral blood flow velocity were investigated.
Results. Target BP level was achieved in 77% of the patients. BP monitoring demonstrated significant reduction in systolic BP (daytime: -9.4%, p<0.001; nighttime: -10.4%, p<0.001) and diastolic BP (-10.6%, p<0,001; -9.9%, p<0.001, respectively). Substantial reduction of LV mass index (-12%, p=0.005) was observed. LV posterior wall and interventricular septal thickness were reduced by 7.6% (p<0.004) and 9.5% (p=0.001), respectively. Carotid IMT decrease (-12.1%, p<0.001) and arterial stiffness reduction in elastic arteries (carotid-femoral PWV decreased by 11.3%, p=0.0001) were registered. Cerebral blood flow velocity, normal at baseline, did not change.
Conclusion. Treatment with a fixed combination of perindopril and indapamide in hypertensive patients is characterized by high antihypertensive efficacy, metabolic neutrality, and positive influence on remodeling of both the heart and large and medium arteries.