Controlled diuretic monotherapy in hypertensive patients: Efficiency and metabolic safety

Abstract

To evaluate the antihypertensive efficiency and metabolic effects of controlled monotherapy with hydrochlorothiazide (HCT) and indapamide retard (IR) in hypertensive patients. The study included 50 patients with Stage II essential hypertension, grades 1-3 blood pressure (BP) elevation, who received 3-month monotherapy with IR (n=25) or HCT (n=25). Changes were determined in BP, blood lipid, glucose, and potassium levels. The efficiency of antihypertensive therapy was evaluated in the entire group and subgroups of patients identified in accordance with the used diuretic and the presence (n=27) or absence (n=23) of therapy at previous stages. A total of 54% of the patients included in the study achieved target BP after 3 months of therapy. The proportion of individuals with normalized BP was comparable in the HCT and IR groups (52 and 56%, respectively) and in previously treated patients and those who used for the first time antihypertensive drugs (51.8 and 56.5%, respectively). Normalization of systolic and diastolic BPs was achieved in 78 and 58% of the patients, respectively. Target BP was achieved in 94,1%, 42,9% and 16,7% of patients with grades 1,2 and 3 hypertension, respectively. IR proved to be metabolically neutral whereas HCT was found to significantly increase the blood levels of triglycerides and glucose by 15.3% (p<0.05) and 12.2% (p<0.05), respectively. Controlled diuretic monotherapy allows BP normalization in more than 50% of the hypertensive patients. HCT and IR have similar antihypertensive efficiency. Because of the negative changes observed in lipid and carbohydrate metabolism with the use of relatively small doses of HCT, IR is a preferential alternative in the long-term treatment of hypertensive patients.