[PP.35.25]: INDAPAMIDE SR IMPACT ON BRACHIAL AND CENTRAL AMBULATORY BLOOD PRESSURE PROFILE IN DIFFICULT-TO-CONTROL ARTERIAL HYPERTENSION. (June 2015)

• Record Type: Journal Article
• Authors: Kobalava>, Z.>; Kotovskaya, Y.; Kravtsova, O.
• Is Part Of: Journal of hypertension. Volume 33(2015)Supplement 1
• Publication Date: 2015-06
• Subjects: Hypertension -- Periodicals; Hypertension -- Periodicals; 616.132005
• DOI: 10.1097/01.hjh.0000468821.96847.fc
• Languages: English
• ISSNs: 1473-5598

Abstract

Abstract : Objective: Ambulatory monitoring of central blood pressure (BP) and arterial stiffness is a new technique for evaluation of antihypertensive drugs efficacy. The aim of the study was to assess changes in ambulatory brachial and central BP and AIx after indapamide SR adjunction to treatment regimen in hypertensive patients. Design and method: Indapamide SR 1, 5 mg was added to 21 hypertensive patients (9 male, age 62 years) with uncontrolled hypertension (clinic BP > 140/90 mmHg, 24-h BP > 130/80 mmHg and/or daytime BP > 135/85 mmHg) despite 8 weeks treatment with combination of an ACE inhibitor and a calcium channel blocker. ABPM was done with BPLab VASOTENS ("OOO Petr Telegin", Nizhniy Novgorod, Russia). Brachial and aortic BP changes as well as changes in 24-h, day- and nighttime AIx were evaluated. p < 0, 05 was considered significant. Results: Significant (p < 0, 05 vs baseline) decrease in 24-h, day- and nighttime BP after 4 weeks of indapamide SR adjunction was observed: for brachial SBP, respectively, from 147 + 13 to 138 + 10, from 148 + 13 to 139 + 10, from 145 + 15 to 134 + 14 mmHg, for brachial pulse pressure (PP) from 56 + 7 to 48 + 9, from 54 + 6 to 46 + 8, from 58 + 10 to 49 + 7 mmHg. For aortic SBP corresponding changes were from 137 + 12 to 128 + 9, from 137 + 12 to 128 + 9, from 137 + 14 to 126 + 13 mmHg, for aortic PP, respectively, 46 + 6 to 36 + 5, from 44 + 6 to 34 + 8, from 49 + 7 to 36 + 6 mmHg. AIx@HR75 bpm decreased at daytime from 27, 3 + 10, 6 to 21, 7 + 11, 1%, at night-time from 31, 4 + 11, 7 to 20, 8 + 9, 5% (p < 0, 05). Increase in PP amplification was observed also and was more evident in nighttime: baseline difference between brachial and aortic PP was 10, 2 + 3, 2 for daytime, 8, 4 + 3, 2 mmHg for nighttime, after indapamide SR treatment 11, 7 + 2, 8 and 11, 2 + 3, 0 mmHg, respectively (p < 0, 05 vs baseline). Conclusions: Indapamide SR adjunction to combination of an ACE inhibitor and a calcium channel blocker decreases significantly either brachial or aortic SBP and PP, as well decreases aortic PP augmentation. Increase in PP amplification mainly in nighttime indicates diminishing of disproportionally high aortic nighttime SBP and PP and it may be clinically beneficial.