Efficacy of indapamide SR compared with enalapril in elderly hypertensive patients with type 2 diabetes.

Aged; Albuminuria/drug therapy; Antihypertensive Agents/adverse effects/therapeutic use; Diabetes Mellitus, Type 2/complications; Enalapril/adverse effects/therapeutic use; Female; Humans; Hypertension/complications/drug therapy; Indapamide/adverse effects/therapeutic use; Kidney Function Tests; Male

Abstract :

[en] BACKGROUND: Blood pressure control is the main influential variable in reducing microalbuminuria in patients with type 2 diabetes. In this subanalysis of the Natrilix SR versus Enalapril Study in hypertensive Type 2 diabetics with micrOalbuminuRia (NESTOR) study, we have compared the effectiveness of indapamide sustained release (SR) and enalapril in reducing blood pressure and microalbuminuria in patients > or =65 years of age. METHODS: Of the 570 hypertensive patients with type 2 diabetes and persistent microalbuminuria in the NESTOR study, 187 (33%) individuals > or =65 years of age were included in this analysis. Of these, 95 patients received indapamide SR 1.5 mg and 92 patients received enalapril 10 mg, taken once daily in both cases. Adjunctive amlodipine and/or atenolol was added if required. RESULTS: The urinary albumin-to-creatinine ratio decreased by 46% in the indapamide SR group and 47% in the enalapril group. Noninferiority of indapamide SR over enalapril was demonstrated (P = .0236; 35% limit of noninferiority) with a ratio of 0.95 (95% CI: 0.68, 1.34). Mean arterial pressure decreased by 18 mm Hg and 15 mm Hg in the indapamide SR and the enalapril groups, respectively (P = .1136). The effects of both treatments seen in these elderly patients were similar to those observed in the main population, although the extent of the reduction in microalbuminuria was slightly higher. Both treatments were well tolerated, and no difference between groups was observed regarding glucose or lipid profiles. CONCLUSION: Indapamide SR is not less effective than enalapril in reducing microalbuminuria and blood pressure in patients aged >65 years of age with type 2 diabetes and hypertension.

Disciplines :

Cardiovascular & respiratory systems
Endocrinology, metabolism & nutrition

Author, co-author :

Puig, Juan Garcia

Marre, Michel

Kokot, Franciszek

Fernandez, Margarita

Jermendy, Gyorgy

Opie, Lionel

Moyseev, Valentin

Scheen, André ; Université de Liège - ULiège > Département des sciences cliniques > Diabétologie, nutrition et maladie métaboliques - Médecine interne générale

Ionescu-Tirgoviste, Constantin

Saldanha, M Helena

More authors (11 more)

Language :

English

Title :

Efficacy of indapamide SR compared with enalapril in elderly hypertensive patients with type 2 diabetes.

Publication date :

2007

Journal title :

American Journal of Hypertension

ISSN :

0895-7061

eISSN :

1941-7225

Publisher :

Elsevier Science, New York, United States - New York

Volume :

Issue :

Pages :

90-7

Peer reviewed :

Peer Reviewed verified by ORBi

Additional URL :

http://www.nature.com/ajh/archive/index.html

Available on ORBi :

since 16 March 2009

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Bibliography

World Health Organization. The Diabetes Programme (2004). http://www.who.int/diabetes/en/ (www.who.int/diabetes/en/). Accessed June 13, 2005.
Haffner A.M. Coronary heart disease in patients with diabetes. N Engl J Med 342 (2000) 1040-1042
American Diabetes Association. Treatment of hypertension in adults with diabetes. Position statement. Diabetes Care 26 (2003) 80S-82S
Gress T.W., Nieto F.J., Shahar E., Wofford M.R., and Brancati F.L. Hypertension and antihypertensive therapy as risk factors for type 2 diabetes mellitus. Atherosclerosis Risk in Communities Study. N Engl J Med 342 (2000) 905-912
Pascual J.M., Rodilla E., Gonzalez C., Perez-Hoyos S., and Redon J. Long-term impact of systolic blood pressure and glycemia on the development of microalbuminuria in essential hypertension. Hypertension 45 (2005) 1125-1130
Park H.Y., Schumock G.T., Pickard A.S., and Akhras K. A Structured review of the relationship between microalbuminuria and cardiovascular events in patients with diabetes mellitus and hypertension. Pharmacotherapy 23 (2003) 1611-1616
Adler A.I., Stevens R.J., and Manley S.E. Development and progression of nephropathy in type 2 diabetes: the United Kingdom Prospective Diabetes Study (UKPDS 64). Kidney Int 63 (2003) 225-232
Nelson R.G., Knowler W.C., Pettitt D.J., Saad M.F., Charles M.A., and Bennett P.H. Assessing risk of overt nephropathy in diabetic patients from albumin excretion in untimed urine samples. Arch Intern Med 151 (1991) 1761-1765
Hillege H.L., Fidler V., Diercks G.F.H., van Gilst W.H., de Zeeuw D., van Veldhuisen D.J., Gans R.O., Janssen W.M., Grobbee D.E., de Jong P.E., and Prevention of Renal and Vascular End Stage Disease (PREVEND) Study Group. Urinary albumin excretion predicts cardiovascular and noncardiovascular mortality in general population. Circulation 106 (2002) 1777-1782
Heart Outcomes Prevention Evaluation Study Investigators. Effects of ramipril on cardiovascular and microvascular outcomes in people with diabetes mellitus: results of the HOPE study and MICRO-HOPE substudy. Lancet 355 (2000) 253-259
Mann J.F., Gerstein H.C., Pogue J., Bosch J., and Yusuf S. Renal insufficiency as a predictor of cardiovascular outcomes and the impact of ramipril: the HOPE randomised trial. Ann Intern Med 134 (2001) 629-636
Sassard J., Bataillard A., and McIntyre H. An overview of the pharmacology and clinical efficacy of indapamide sustained release. Fund Clin Pharmacol 19 (2005) 637-645
Marre M., Garcia-Puig J., Kokot F., Fernandez M., Jermendy G., Opie L., Moyseev V., Scheen A., Ionescu-Tirgoviste C., Saldanha M.H., Halabe A., Williams B., Mion Junior D., Ruiz M., Hermansen K., Tuomilehto J., Finizola B., Gallois Y., Amouyel P., Ollivier J.P., and Asmar R. Equivalence of indapamide SR and enalapril on microalbuminuria reduction in hypertensive patients with type 2 diabetes: the NESTOR study. J Hypertens 22 (2004) 1613-1622
Choi B.C., and Shi F. Risk factors for diabetes mellitus by age and sex: results of the National Population Health Survey. Diabetologia 44 (2001) 1221-1231
Baruch L. Hypertension and the elderly: more than just blood pressure control. J Clin Hypertens (Greenwich) 6 (2004) 249-255
Bauer J.H. Age-related changes in the renin-aldosterone system. Physiological effects and clinical implications. Drugs Aging 3 (1993) 238-245
Cockcroft D.W., and Gault M.H. Prediction of creatinine clearance from serum creatinine. Nephron 16 (1976) 31-41
Dunnett C.W., and Gent M. An alternative to the use of two-sided tests in clinical trials. Stat Med 15 (1996) 1729-1738
Barnett A.H., Bain S.C., Bouter P., Karlberg B., Madsbad S., Jervell J., Mustonen J., and Diabetics Exposed to Telmisartan and Enalapril Study Group. Angiotensin-receptor blockade versus converting-enzyme inhibition in type 2 diabetes and nephropathy. N Engl J Med 351 (2004) 1952-1961
Chobanian A.V., Bakris G.L., Black H.R., Cushman W.C., Green L.A., Izzo Jr. J.L., Jones D.W., Materson B.J., Oparil S., Wright Jr. J.T., Roccella E.J., Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure, National Heart, Lung, and Blood Institute, and National High Blood Pressure Education Program Coordinating Committee. Seventh report of the Joint National Committee on Prevention, Detection, Evaluation and Treatment of High Blood Pressure: the JNC 7 report. J Am Med Assoc 289 (2003) 2560-2572
Levey A.S., Coresh J., Balk E., Kausz A.T., Levin A., Steffes M.W., Hogg R.J., Perrone R.D., Lau J., Eknoyan G., and National Kidney Foundation. National Kidney Foundation practice guidelines for chronic kidney disease: evaluation, classification and stratification. Ann Intern Med 139 (2003) 137-147
Mogensen C.E. Microalbuminuria predicts clinical proteinuria and early mortality in maturity-onset diabetes. N Engl J Med 310 (1984) 356-360
Young J.H., Klag M.J., Muntner P., Whyte J.L., Pahor M., and Coresh J. Blood pressure and decline in kidney function: findings from the Systolic Hypertension in the Elderly Program (SHEP). J Am Soc Nephrol 13 (2002) 2276-2282
Curb J.D., Pressel S.L., Cutler J.A., Savage P.J., Applegate W.B., Black H., Camel G., Davis B.R., Frost P.H., Gonzalez N., Guthrie G., Oberman A., Rutan G.H., and Stamler J. Effect of diuretic-based antihypertensive treatment on cardiovascular disease in older diabetic patients with isolated systolic hypertension. J Am Med Assoc 276 (1996) 1886-1892
ALLHAT officers and coordinators for the ALLHAT collaborative research group. Major outcomes in high-risk hypertensive patients randomized to angiotensin-converting enzyme inhibitor or calcium channel blocker vs diuretic: the Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT). J Am Med Assoc 288 (2002) 2981-2997
Redon J., Baldo E., Lurbe E., Bertolin V., Lozano J.V., Miralles A., and Pascual J.M. Microalbuminuria, left ventricular mass and ambulatory blood pressure in essential hypertension. Kidney Int 55 Suppl (1996) S81-S84
Gosse P., Sheridan D., Zannad F., Dubourg O., Gueret P., Karpov Y., de Leeuw P.W., Palma-Gamiz J.L., Pessina A., Motz W., Degaute J.P., and Chastang C. Regression of left ventricular hypertrophy in hypertensive patients treated with indapamide SR 1.5 mg versus enalapril 20 mg: the LIVE study. J Hypertens 18 (2000) 1465-1475
Ambrosioni E., Safar M., Degaute J.P., Malin P.L., MacMahon M., Pujol D.R., de Cordoue A., and Guez D. Low-dose antihypertensive therapy with 1.5mg sustained-release indapamide: results of randomised double-blind controlled studies. J Hypertens 16 (1998) 1677-164
Weidmann P. Metabolic profile of Indapamide sustained-release in patients with hypertension. Data from three randomised double-blind studies. Drug Safety 24 (2001) 1155-1165
Mancia G., Omboni S., Agabiti-Rosei E., Casati R., Fogari R., Leonetti G., Montemurro G., Nami R., Pessina A.C., Pirrelli A., and Zanchetti A. Antihypertensive efficacy of manidipine and enalapril in hypertensive diabetic patients. J Cardiovasc Pharmacol 35 (2000) 926-931