August 19, 2003Diabetic Medicine
Comparative metabolic effects of hydrochlorothiazide and indapamide in hypertensive diabetic patients receiving ACE inhibitor therapy
Why the study?
Does hydrochlorothiazide compared to indapamide improve metabolic profiles in diabetic hypertensive patients on ACE inhibitor therapy?
Population
18 diabetic hypertensive patients stabilized on ACE inhibitor monotherapy (fosinopril 20 mg/day)
Comparison
Hydrochlorothiazide 12.5 mg once daily added to… vs Indapamide 2.5 mg once daily added to fosinopril…
Design
RCT, randomized crossover, open-label, blinded endpoint
Follow-up
8 weeks per treatment period
Authors
Discussion
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Implication
Supports hydrochlorothiazide over indapamide for metabolic safety in diabetic hypertension on ACE inhibitors; extends RCT evidence on thiazide selection.
Structured PICO
Does hydrochlorothiazide compared to indapamide improve metabolic profiles in diabetic hypertensive patients on ACE inhibitor therapy?
P
Population
18 diabetic hypertensive patients stabilized on ACE inhibitor monotherapy (fosinopril 20 mg/day)
I
Intervention
Hydrochlorothiazide 12.5 mg once daily added to fosinopril for 8 weeks
C
Comparator
Indapamide 2.5 mg once daily added to fosinopril for 8 weeks (crossover design)
O
Outcome
Metabolic responses (blood pressure, heart rate, fasting lipid profile, urinary albumin:creatinine ratio, plasma potassium, HbA1c) at the end of each 8-week treatment periodsurrogate
In diabetic hypertensive patients on fosinopril, adding low-dose hydrochlorothiazide resulted in a similar or superior metabolic profile (lower HbA1c, higher potassium) compared to indapamide.
Cite This Study
Krum et al. (2003) studied this question.