What question did this study set out to answer?

To review the efficacy, safety, and end-organ protective effects of the highest fixed dose of perindopril/indapamide (8 mg/2.5 mg) in patients with hypertension.

July 23, 2009Current Medical Research and Opinion

Evaluation of high dose of perindopril/indapamide fixed combination in reducing blood pressure and improving end-organ protection in hypertensive patients

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Why the study?

Does high-dose fixed-combination perindopril/indapamide reduce blood pressure and improve end-organ protection in hypertensive patients?

Population

Hypertensive patients from three published randomised trials (a dose-finding study, PICXEL, and PREMIER).

Comparison

Fixed-combination perindopril 8 mg/indapamide… vs Placebo or lower dose fixed-combination…

Design

Review

Follow-up

8 weeks (for the dose-finding study)

Authors

JMJean‐Jacques MouradGeneral / Preventive / Lipids SJSylvain Le JeuneInserm

Discussion

Member takes

Implication

High-dose perindopril/indapamide may enhance BP control in hypertension; leaves open long-term outcome benefits beyond short-term trial data.

Key Points

To review the efficacy, safety, and end-organ protective effects of the highest fixed dose of perindopril/indapamide (8 mg/2.5 mg) in patients with hypertension.
Synthesized data from three published randomized clinical trials, including an 8-week dose-finding trial, the PICXEL trial, and the PREMIER trial.
Evaluated blood pressure reductions alongside surrogate markers of cardiac protection (left ventricular mass index) and renal protection (albumin excretion rate), while monitoring safety profiles such as potassium levels.
In the dose-finding trial, 8 weeks of Per8/Ind2.5 significantly reduced supine SBP/DBP by -23/-15 mmHg compared to -5/-5 mmHg for placebo, with incremental reductions across dose doublings.
Doubling therapy from Per4/Ind1.25 to Per8/Ind2.5 caused additional SBP/DBP decreases of 16.3/8.1 mmHg (p < 0.0001) in PICXEL and 2.5/2.6 mmHg in PREMIER, increasing treatment response rates to 68% and 45%, respectively.
Per8/Ind2.5 achieved a 17.5 g/m² reduction in left ventricular mass in PICXEL (p < 0.0001) and a 45% decrease in albumin excretion rate in PREMIER (p < 0.0001) without adversely affecting safety or potassium levels.

Structured PICO

Does high-dose fixed-combination perindopril/indapamide reduce blood pressure and improve end-organ protection in hypertensive patients?

Population

Hypertensive patients from three published randomised trials (a dose-finding study, PICXEL, and PREMIER).

Intervention

Fixed-combination perindopril 8 mg/indapamide 2.5 mg.

Comparator

Placebo (in the dose-finding study) or lower dose fixed-combination perindopril 4 mg/indapamide 1.25 mg (in PICXEL and PREMIER trials).

Outcome

Blood pressure reduction (systolic and diastolic) and end-organ protection (left ventricular mass and albumin excretion rate).surrogate

High-dose fixed-combination perindopril 8 mg/indapamide 2.5 mg provides significant incremental blood pressure reduction and end-organ protection in hypertensive patients while remaining safe and well-tolerated.

Cite This Study

Mourad et al. (2009) studied this question.

synapsesocial.com/papers/6a7cb9cdf501f50849cf86e5 https://doi.org/10.1185/03007990903186787

Topics

Hypertension management

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Implication

High-dose perindopril/indapamide may enhance BP control in hypertension; leaves open long-term outcome benefits beyond short-term trial data.

Evaluation of high dose of perindopril/indapamide fixed combination in reducing blood pressure and improving end-organ protection in hypertensive patients

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Topics

Evaluation of high dose of perindopril/indapamide fixed combination in reducing blood pressure and improving end-organ protection in hypertensive patients

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

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Topics

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