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Published on: May 26, 2022

Fixed combination of perindopril and indapamide at low dose improves endothelial function in essential hypertensive

Robinson Joannides1, Jeremy Bellien, Celine Thurlure

  • 1Department of Pharmacology, Rouen University Hospital & INSERM U644 (IFRMP 23), Institute for Biomedical Research, University of Rouen, Rouen Cedex, France. robinson.joannides@chu-rouen.fr

American Journal of Hypertension
|April 30, 2008
PubMed

Insights

Low-dose fixed combination of angiotensin-converting enzyme inhibitors (ACEIs) and diuretics improve endothelial function in hypertensive patients. This treatment enhances radial artery flow-mediated dilation, suggesting a protective effect on blood vessels.

Area of Science:

  • Cardiovascular Medicine
  • Pharmacology
  • Hypertension Research

Background:

  • Fixed-dose combinations of ACE inhibitors (ACEIs) and thiazide diuretics are common first-line treatments for essential hypertension.
  • The impact of these low-dose combinations on conduit artery endothelial dysfunction has not been previously established.

Purpose of the Study:

  • To investigate the effect of a low-dose fixed combination of perindopril-indapamide on endothelial function in hypertensive patients.
  • To assess the dose-dependent effects of this combination on radial artery endothelial function.

Main Methods:

  • A double-blind, randomized, crossover study involving 13 hypertensive patients and 13 matched controls.
  • Patients received placebo, low-dose (D1), or double-dose (D2) perindopril-indapamide.
  • Radial artery diameter and flow were measured using echotracking and Doppler during flow-mediated dilation (FMD) induced by post-ischemic hyperemia (PIH).

Main Results:

  • Hypertensive patients exhibited increased mean arterial pressure (MAP) and reduced PIH duration (t(1/2)) and FMD compared to controls.
  • Only the higher dose (D2) significantly reduced MAP and increased t(1/2) compared to placebo.
  • Both low-dose (D1) and high-dose (D2) combinations significantly improved radial artery FMD.

Conclusions:

  • A fixed low-dose combination of ACEI/diuretic effectively improves endothelial function in hypertensive patients.
  • The findings suggest a direct positive impact on conduit artery endothelium, potentially contributing to vascular protection.
  • This combination therapy may offer significant benefits beyond blood pressure reduction.
Abstract

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