Indapamide reduces hypertensive left ventricular hypertrophy: an international multicenter study

Area of Science:

• Cardiology
• Pharmacology
• Hypertension Research

Background:

• Left ventricular hypertrophy (LVH) is a significant predictor of poor prognosis in patients with hypertension.
• Effective management of hypertension is crucial for reducing cardiovascular risk, including LVH regression.

Purpose of the Study:

• To compare the efficacy of indapamide (IND) in regressing left ventricular hypertrophy (LVH) against nifedipine (NFD), enalapril (ENL), atenolol (ATL), and hydrochlorothiazide (HCTZ).
• To evaluate the effect of a 6-month treatment regimen on left ventricular mass index (LVMI) in hypertensive patients.

Main Methods:

• Four parallel, double-blind studies were conducted involving 151 hypertensive patients with elevated LVMI and diastolic blood pressure between 95-120 mm Hg.
• Patients were randomized to receive either indapamide (2.5 mg/day) or a comparator drug (nifedipine, enalapril, atenolol, or hydrochlorothiazide) for 6 months.
• Echocardiography was used to measure left ventricular mass index (LVMI) at baseline and after 6 months of treatment.

Main Results:

• Indapamide demonstrated a significant reduction in LVMI (p < 0.001) from baseline to 6 months.
• Significant LVH regression was observed with indapamide compared to hydrochlorothiazide (p < 0.001), nifedipine (p < 0.001), enalapril (p < 0.001), and atenolol (p < 0.001).
• All tested drugs, except hydrochlorothiazide, significantly reduced diastolic blood pressure and induced a comparable reduction in left ventricular mass.

Conclusions:

• Indapamide is effective in promoting regression of left ventricular hypertrophy in hypertensive patients.
• The antihypertensive effects of indapamide are associated with significant improvements in cardiac structure, comparable to other major drug classes.