Efficacy of Indapamide SR Compared With Enalapril in Elderly Hypertensive Patients With Type 2 Diabetes

Juan Garcia Puig, Michel Marre, Franciszek Kokot, Margarita Fernandez, G. Jermendy, Lionel Opie, Valentin Moyseev, André Scheen, Constantin Ionescu-Tirgoviste, M. Helena Saldanha, Aaron Halabe, Bryan Williams, Decio Mion, Maximino Ruiz, Kjeld Hermansen, Jaakko Tuomilehto, Bartolomé Finizola, Yves Gallois, Philippe Amouyel, Jean Pierre OllivierRoland Asmar

Research output: Contribution to journalArticle

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Abstract

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 ≥65 years of age. Methods: Of the 570 hypertensive patients with type 2 diabetes and persistent microalbuminuria in the NESTOR study, 187 (33%) individuals ≥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.

Original languageEnglish
Pages (from-to)90-97
Number of pages8
JournalAmerican Journal of Hypertension
Volume20
Issue number1
DOIs
Publication statusPublished - Jan 2007

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Indapamide
Enalapril
Type 2 Diabetes Mellitus
Blood Pressure
Amlodipine
Atenolol
Albumins
Creatinine
Arterial Pressure
Hypertension
Lipids
Glucose
Therapeutics

Keywords

  • enalapril
  • Hypertension
  • indapamide SR
  • microalbuminuria
  • type 2 diabetes

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Efficacy of Indapamide SR Compared With Enalapril in Elderly Hypertensive Patients With Type 2 Diabetes. / Puig, Juan Garcia; Marre, Michel; Kokot, Franciszek; Fernandez, Margarita; Jermendy, G.; Opie, Lionel; Moyseev, Valentin; Scheen, André; Ionescu-Tirgoviste, Constantin; Saldanha, M. Helena; Halabe, Aaron; Williams, Bryan; Mion, Decio; Ruiz, Maximino; Hermansen, Kjeld; Tuomilehto, Jaakko; Finizola, Bartolomé; Gallois, Yves; Amouyel, Philippe; Ollivier, Jean Pierre; Asmar, Roland.

In: American Journal of Hypertension, Vol. 20, No. 1, 01.2007, p. 90-97.

Research output: Contribution to journalArticle

Puig, JG, Marre, M, Kokot, F, Fernandez, M, Jermendy, G, Opie, L, Moyseev, V, Scheen, A, Ionescu-Tirgoviste, C, Saldanha, MH, Halabe, A, Williams, B, Mion, D, Ruiz, M, Hermansen, K, Tuomilehto, J, Finizola, B, Gallois, Y, Amouyel, P, Ollivier, JP & Asmar, R 2007, 'Efficacy of Indapamide SR Compared With Enalapril in Elderly Hypertensive Patients With Type 2 Diabetes', American Journal of Hypertension, vol. 20, no. 1, pp. 90-97. https://doi.org/10.1016/j.amjhyper.2006.05.018
Puig, Juan Garcia ; Marre, Michel ; Kokot, Franciszek ; Fernandez, Margarita ; Jermendy, G. ; Opie, Lionel ; Moyseev, Valentin ; Scheen, André ; Ionescu-Tirgoviste, Constantin ; Saldanha, M. Helena ; Halabe, Aaron ; Williams, Bryan ; Mion, Decio ; Ruiz, Maximino ; Hermansen, Kjeld ; Tuomilehto, Jaakko ; Finizola, Bartolomé ; Gallois, Yves ; Amouyel, Philippe ; Ollivier, Jean Pierre ; Asmar, Roland. / Efficacy of Indapamide SR Compared With Enalapril in Elderly Hypertensive Patients With Type 2 Diabetes. In: American Journal of Hypertension. 2007 ; Vol. 20, No. 1. pp. 90-97.
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AU - Marre, Michel

AU - Kokot, Franciszek

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AU - Jermendy, G.

AU - Opie, Lionel

AU - Moyseev, Valentin

AU - Scheen, André

AU - Ionescu-Tirgoviste, Constantin

AU - Saldanha, M. Helena

AU - Halabe, Aaron

AU - Williams, Bryan

AU - Mion, Decio

AU - Ruiz, Maximino

AU - Hermansen, Kjeld

AU - Tuomilehto, Jaakko

AU - Finizola, Bartolomé

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AU - Amouyel, Philippe

AU - Ollivier, Jean Pierre

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N2 - 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 ≥65 years of age. Methods: Of the 570 hypertensive patients with type 2 diabetes and persistent microalbuminuria in the NESTOR study, 187 (33%) individuals ≥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.

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