The effect of indapamide versus hydrochlorothiazide on ventricular and arterial function in patients with hypertension and diabetes: results of a randomized trial.

Objective The objective of this study is to compare the effects of 2 types of diuretics, indapamideand hydrochlorothiazide, added to an angiotensin-converting enzyme inhibitor, on ventricular and arterial functions in patients with hypertension and diabetes. Methods This is a prospective, randomized, active-controlled, PROBE design study in 56 patients (57 ± 9 years, 52% men) with mild-to-moderate hypertension and type 2 diabetes, with normal ejection fraction, randomized to either indapamide(1.5 mg Slow Release (SR)/day) or hydrochlorothiazide(25 mg/d), added to quinapril(10-40 mg/d). All patients had conventional, tissue Doppler and speckle tracking echocardiographyand assessment of endothelial and arterial functions and biomarkers, at baseline and after 6 months. Results Baseline characteristics were similar between groups; systolic and diastolic blood pressures decreased similarly, by 15% and 9% on indapamideand by 17% and 10% on hydrochlorothiazide( P P P P P Conclusion Indapamidewas found to improve measures of endothelial and arterial functions and to increase longitudinal left ventricular function compared with hydrochlorothiazidein patients with hypertension and diabetes, after 6 months of treatment. This study suggests that indapamide, a thiazide-like diuretic, has important vascular effects that can improve ventriculoarterial coupling.