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Hypertension in elderly patients. A comparative study between indapamide and hydrochlorothiazide
1Centre Hospitalier Universitaire Sherbrooke, Faculty of Medicine, Quebec, Canada.
The American Journal of Medicine
|January 29, 1988
Summary
Indapamide effectively lowers blood pressure in elderly patients with hypertension. Unlike hydrochlorothiazide, indapamide maintains serum electrolyte balance and does not significantly increase uric acid levels.
Area of Science:
- Gerontology
- Cardiology
- Pharmacology
Background:
- Diuretic therapy is a primary treatment for hypertension in the elderly.
- Traditional diuretics like thiazides carry risks of significant side effects.
- Indapamide, a nonthiazide diuretic, shows promise for blood pressure reduction at low doses.
Purpose of the Study:
- To compare the efficacy and safety of indapamide versus hydrochlorothiazide in elderly hypertensive patients.
- To evaluate the effects of indapamide and hydrochlorothiazide on blood pressure and serum chemistry.
Main Methods:
- A randomized, controlled trial involving 47 elderly hypertensive patients (ages 65-91).
- Patients initially underwent a six-week placebo period.
- Subsequent treatment involved either indapamide (2.5 mg/day) or hydrochlorothiazide (50 mg/day) for 48 weeks.
Main Results:
- Indapamide demonstrated superior control of systolic and diastolic blood pressure compared to hydrochlorothiazide.
- Indapamide did not significantly alter serum sodium or potassium levels.
- Hydrochlorothiazide led to significant decreases in serum sodium and potassium, and a notable increase in serum uric acid.
Conclusions:
- Indapamide offers a favorable alternative for managing hypertension in the elderly due to its efficacy and better serum chemistry profile.
- Indapamide's lack of adverse effects on electrolytes and uric acid distinguishes it from hydrochlorothiazide.
- The study highlights indapamide's potential for improved patient outcomes in geriatric hypertension management.