Diuretic treatment and serum lipoproteins: Effects of tienilic acid and indapamide

Summary Treatment with the commonly used diuretic, chlorthalidone, has previously been found to increase the serum low-density-lipoprotein cholesterol (LDL-C) fraction. Therefore, the effects of two new agents, tienilic acid (a combined diuretic-uricosuric) and indapamide on serum lipid and lipoprotein levels were assessed. Six weeks of treatment with tienilic acid, 250 mg/day, markedly decreased serum uric acid and significantly increased LDL-C and triglycerides in 16 men. In contrast, indapamide 2.5 mg/day, had no apparent influence on serum lipids or lipoproteins in 18 men.Supported in part by the Swiss National Science Foundation     

A preliminary controlled evaluation of the antihypertensive effect of indapamide

Summary

A controlled, single-blind trial was carried out in 10 hypertensive patients to compare the effectiveness of a single daily dose (2.5 mg to 5?mg) of indapamide with that of placebo. Blood pressure was measured with a bias-free sphygmomanometer. Indapamide produced a significant reduction in mean systolic and diastolic pressures in both supine and erect positions. It was generally well tolerated: few side-effects were reported and no significant changes were noted in laboratory tests. It is concluded that further long-term studies of indapamide are indicated in larger numbers of patients.     

探讨氨氯地平联合吲达帕胺对高血压合并冠心病血脂、血压的影响

目的：研究氨氯地平联合吲达帕胺治疗高血压合并冠心病的临床疗效及其对患者血脂、血压指标的影响。方法以随机数表法将该院160例高血压合并冠心病患者分为观察组与对照组,两组均为80例,对照组给予单一吲达帕胺治疗,观察组采取氨氯地平联合吲达帕胺治疗,比较两组血脂、血压指标改变,并对临床疗效及安全性进行分析。结果①治疗后观察组SBP、DBP、TC、TG、LDL为（117.87±10.67）mmHg、（81.67±6.95）mmHg、（4.36±0.68）mol/L、（1.64±0.58）mol/L、（3.84±0.47）mol/L VS 对照组（142.36±9.80）mmHg、（92.44±8.21）mmHg、（5.76±0.75）mol/L、（3.60±0.47）mol/L、（5.03±0.33）mol/L 显著较低（P＜0.05）,HDL两组比较（1.42±0.21）mol/L VS（1.16±0.17）mol/L,观察组显著较高（P＜0.05）;②观察组治疗有效率92.50% VS 对照组73.75%显著较高（P＜0.05）;③观察组总有效率96.25%VS 对照组82.50%显著较高,对比差异有统计学意义（P＜0.05）;④观察组2例头痛,1例头晕,不良反应发生率3.75%VS 对照组5.00%差异无统计学意义（P＞0.05）。结论氨氯地平联合吲达帕胺治疗高血压合并冠心病临床效果显著,可改善患者血脂及血压水平,无明显不良反应,具有较高的临床应用价值。     

替米沙坦和吲哒帕胺缓释片联用对高血压患者降压作用的临床观察

目的观察联用替米沙坦和吲哒帕胺缓释片对原发性高血压患者的降压质量。方法为自身对照方式。选择103例新发的1、2级原发性高血压患者,每日晨服替米沙坦40～80mg和吲哒帕胺缓释片1.5mg,共8周,观察用药前后的坐位血压及24h动态血压。结果8周后,通过测坐位血压评价降压总有效率达92.2%。根据24h动态血压监测结果,全组收缩压与舒张压谷/峰比值分别为98%与96%。能逆转异常的血压昼夜节律,逆转率达81.5%(22/27)。结论联用替米沙坦和吲哒帕胺缓释片对原发性高血压患者的降压质量很高,能有效平稳控制24h血压,有效抑制血压变异及晨峰现象,恢复异常的血压昼夜节律。     

Blood pressure control and acceptability of Perindopril and its fixed dose combinations with Amlodipine or Indapamide,in younger patients with hypertension

Objective

Recent hypertension guidelines recommend initiation of treatment with a fixed dose combination of two drugs for more effective and quicker blood pressure control. Few of these have been assessed for efficacy and acceptability. This study examines the short term blood pressure control and acceptability of perindopril, with or without its fixed dose combinations (FDC) with amlodipine and Indapamide in younger patients.

Methods

In a multicentre prospective observational study, patients with stage 1 hypertension were prescribed perindopril 4 mg per day. Those with stage 2 or 3 hypertension were prescribed a single tablet per day of 4 mg perindopril and 5 mg amlodipine (COVERSYL AM), or 4 mg perindopril and 1.25 mg indapamide (COVERSYL PLUS)for 45 days. The primary outcomes were the frequency of patients achieving blood pressure control and the adverse effect of pedal edema.

Results

Of 426 patients, with a mean age of 45 years, distributed throughout India, and an average (SD) baseline systolic/diastolic blood pressure of 157.2 (13.5)/98.6 (7.4), 303 (71.1%) achieved blood pressure control. Mean (SD) SBP/DBP decreased from baseline by 26.9 (12.6), and DBP by 15.4 (7.2) mm Hg. Few patients discontinued treatment, and the frequency of cough that interfered with sleep and ankle edema was low.

Conclusion

In patients requiring combination antihypertensive treatment, the regimen of perindopril alone or its FDC with Indapamide or amlodipine reduces blood pressure effectively, resulting in high rates of blood pressure control over the short term, with a low frequency of side effects including cough and pedal edema.     

吲达帕胺联合依那普利治疗糖尿病合并高血压的可行性研究

目的：分析吲达帕胺联合依那普利治疗糖尿病合并高血压的临床效果及可行性;方法：随机将我院收治的70例患者分为对照组和观察组,对照组主要采用依那普利治疗,观察组在对照组治疗的基础上加用吲达帕胺治疗,观察两组患者血糖、血钾、血压水平,以及治疗效果;结果：血钾、血糖方面,两组患者治疗前后检测比较,P＞0.05;治疗后,观察组血糖低于对照组,两组比较,P＜0.05;血压方面,两组患者的舒张压和收缩压均有所下降,观察组下降效果优于对照组,两组比较,P＜0.05;观察组血压控制的总有效率为85.71%,对照组为65.71%,两组比较差异显著具有统计学意义(P＜0.05)。结论：对糖尿病合并高血压患者行吲达帕胺联合依那普利治疗效果显著,不良反应少,安全性和可行性较高。     

五厂家吲达帕胺片溶出度研究

目的建立吲达帕胺片的溶出度试验方法,对5厂家生产的吲达帕胺片的含量和溶出度进行测定。方法0.05M pH 6.8的磷酸盐缓冲液作为溶出介质,采用转篮法测定溶出度,转速为100r.m in-1,温度为(37.0±0.5)℃;用紫外分光光度法测定含量,测定波长为242nm,并对溶出参数进行了统计学处理。结果各厂家吲达帕胺片的溶出参数(T 50、Td、m)有显著性差异(P<0.01)。结论不同厂家生产的吲达帕胺片的溶出度明显不一致,进行溶出度检查有助于控制质量。     

Preparation of Indapamide slow-release pellets

During the process of developing a slow-release formulation of indapamide, researchers created a drug-containing pellet coated with Eudragit RS100 (Rohm GMbH & Co. KG, Darmstadt, Germany) to control the rate at which the drug was released. The two main variables were the agglomerants used in the pellet preparation and the amount of Eudragit RS100 used to coat them. The optimal outcome was indicated by the greatest number of drug-containing pellets recovered through an 18- to 24-mesh sieve and a satisfactory 24-hour release curve. The kinetics of dissolution fit the Higuchi kinetics model. Stability tests of the drug pellets showed no notable changes in the rate of drug release, related substances (mean byproducts or impurities from interactions or decompositions), and drug content.     

中风患者脉压特征及降压治疗后的变化和预后转归

目的探讨中风患者脉压的变化特点和降压治疗的影响以及对预防中风再发的作用。方法将80例中风患者随机分为两组，分别予培哚普利与吲哒帕胺联合治疗或安慰剂治疗4年，观察血压、血钠、血钾、血肌酐及中风、心血管事件的发生情况。结果老年中风患者舒张压随着年龄并无继续上升，但脉压则显著增高(P＜0．05)，并与血钠水平呈正相关(P＜0．01)，与安慰剂组比较，联合治疗组脉压下降，血钠浓度降低，中风和总心血管事件发生率较低(P值均＜0．05)。结论老年患者、尤其是出现动脉硬化后，应密切注重对脉压的控制，以达到最大限度改善预后的目的，培哚普利与吲哒帕胺联合治疗是有效手段之一。     

吲达帕胺缓释片的含量测定

目的 建立高效液相色谱法测定吲达帕胺缓释片含量。方法 以十八烷基硅烷键合硅胶为固定相，乙酰苯胺为内标，甲醇-水-冰醋酸（45：55：0．1）为流动相，流速1ml／min，检测波长240hm，测定吲达帕胺缓释片的含量。结果 在16．4～57．41μg／ml范围内吲达帕胺呈线性关系。回收率好。结论 本法可测定吲达帕胺缓释片的含量。