Indapamide treatment in patients with a history of stroke prevents one stroke for every 48 patients treated (NNT 47.8; 95% CI 29.6-126.6) and significantly reduces systolic blood pressure.
Meta-Analysis (n=10,108)
Double-blind
Randomized
Does indapamide reduce cardiovascular morbidity, blood pressure, and left ventricular mass index compared to placebo or active controls?
Indapamide is effective in preventing recurrent stroke, reducing blood pressure, and decreasing left ventricular mass index, with a safety profile comparable to placebo.
Number Needed to Treat: 47.8 (95% CI 29.6–126.6)
Number Needed to Treat: 47.8
First-line antihypertensive treatment’s drugs have to be able to decrease the cardiovascular morbidity and mortality. This kind of efficacy of thiazide-type diuretics has been published earlier in several studies. The efficacy of indapamide was investigated in several studies, but there is no analysis which is including all of the indapamide-studies. Objective: We conducted a meta-analysis of all relevant randomized-controlled-trials with indapamide. Efficacy of indapamide was analyzed in different cardiovascular and safety outcomes. Methods: We searched the MEDLINE database 1995–2006 for indapamide-trials. Only double-blind, parallel-group design trials were involved. Both the fixed effect model and the random effect model were used for data synthesis, results were probed with Mantel–Hanzel test and inverse variance test. Results: Data were combined from 9 trials that included 10,108 patients. Indapamide treatment of 48 patients with a history of stroke prevents one stroke (NNT = 47.8 95% CI: 29.6–126.6). Data from 5 trials including 7,085 patients show that indapamide is superior to placebo in reducing blood pressure, the differences are: 7.28 mm Hg (95% CI: 6.37–8.19) in systolic blood pressure and 3.50 mm Hg (95% CI: 2.99–4.01) in diastolic blood pressure. Data from 5 trials including 2,856 patients show that indapamide is superior to active controls in reducing systolic blood pressure, the difference is significant: 1.30 mm Hg (95% CI: 0.28–2.31). The difference in diastolic blood pressure was not significant. Data of 505 patients show that indapamide reduced left ventricular mass index significantly more than enalapril 20 mg, the difference is 6.50 g/m 2 (95% CI: 0.81–12.19). Data of 6,206 patients show that the frequency of adverse drug reaction is similar in the indapamide and placebo groups (RR = 0.97 95% CI: 0.76–1.22). Conclusions: Indapamide is efficacious in the prevention of further stroke, reduces effectively the blood pressure and the left ventricular mass index. Indapamide treatment is well tolerated.
Brodszky et al. (Sun,) conducted a meta-analysis in Hypertension and cardiovascular disease (n=10,108). Indapamide vs. Placebo or active controls (e.g., enalapril) was evaluated on Stroke (NNT 47.8, 95% CI 29.6-126.6). Indapamide treatment in patients with a history of stroke prevents one stroke for every 48 patients treated (NNT 47.8; 95% CI 29.6-126.6) and significantly reduces systolic blood pressure.
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