1. Perindopril/indapamide Combination More Effective Than Enalapril in Reducing Blood Pressare and Left Ventricular Mass: the Picxel Study
- Author
-
Peter W. de Leeuw, Olivier Dubourg, Yuri Karpov, Jean-Paul Degaute, Lajos Matos, Roland E. Schmieder, Dieter Magometschnigg, Björn Dahlöf, Philippe Gosse, P. Guéret, Giovanni de Simone, Juan García-Puig, Dahlof, B, Gosse, P, Guret, P, Dubourg, O, DE SIMONE, Giovanni, Schmieder, R, Karpov, Y, GARCA PUIG, J, Matos, L, DE LEEUW, Pw, Degaute, Jp, and Magometschnigg, D.
- Subjects
Adult ,Male ,medicine.medical_specialty ,Physiology ,medicine.medical_treatment ,Heart Ventricles ,Blood Pressure ,Pharmacology ,Left ventricular hypertrophy ,Double-Blind Method ,Internal medicine ,Internal Medicine ,medicine ,Perindopril ,Humans ,cardiovascular diseases ,Enalapril ,Perindopril/indapamide ,Antihypertensive Agents ,Aged ,business.industry ,Indapamide ,Middle Aged ,medicine.disease ,Blood pressure ,Treatment Outcome ,Echocardiography ,ACE inhibitor ,Hypertension ,Cardiology ,Potassium ,Regression Analysis ,Drug Therapy, Combination ,Female ,Hypertrophy, Left Ventricular ,Diuretic ,Cardiology and Cardiovascular Medicine ,business ,circulatory and respiratory physiology ,medicine.drug - Abstract
OBJECTIVE: Few data are available comparing the effects of monotherapy and combination therapy on target organ damage. The PICXEL study compared the efficacy of a strategy based on first-line combination with perindopril/indapamide versus monotherapy with enalapril in reducing left ventricular hypertrophy (LVH) in hypertensive patients. METHODS: In this 1-year multicentre randomized double-blind study, patients received an increasing dosage of perindopril/indapamide (n = 284) or enalapril (n = 272). Changes in blood pressure and echocardiographic measures of LVH were assessed from baseline to the end of treatment. Reading of the echocardiograms was central and blinded for therapy, patient and sequence. RESULTS: Systolic and diastolic blood pressure decreased significantly more in the perindopril/indapamide than in the enalapril group (P < 0.0001 and P = 0.003). The left ventricular mass index decreased by 13.6 +/- 23.9 g/m(2) (mean +/- SD) with perindopril/indapamide (P < 0.0001) and 3.9 +/- 23.9 g/m(2) with enalapril (P < 0.005); these decreases were significantly different (P < 0.0001). The left ventricular internal diameter, posterior and interventricular septal wall thickness decreased significantly with perindopril/indapamide (P < or = 0.0001); the interventricular septal wall thickness decreased significantly with enalapril (P < 0.001). Both treatments were well tolerated. CONCLUSION: A strategy based on first-line combination with perindopril/indapamide achieved better blood pressure decrease with a significantly greater degree of LVH reduction than a strategy based on monotherapy with enalapril in hypertensive patients with LVH.
- Published
- 2005