Antihypertensive efficacy and tolerability of low-dose perindopril/indapamide combination compared with losartan in the treatment of essential hypertension

The aim of the study was to evaluate the antihypertensive efficacy and tolerability of the low-dose combination of the angiotensin-converting enzyme inhibitor perindopril 2 mg plus the diuretic indapamide 0.625 mg (P/I) compared with the angiotensin II antagonist losartan 50 mg (L50) in the treatment of essential hypertension. Patients (n=277) were randomised, double-blind and allocated to receive either PII or L50 once daily for a period of 12 weeks. Responder and normalisation rates in the two groups were compared by a chi(2) test. Ambulatory blood pressure monitoring results were compared using the one-tailed Student's t-test. Normalisation rates were significantly greater in the P/I group (76.0%) than in the L50 group (60.0%) (p=0.009). Responder rates were significantly higher in the PII group (91.7%) than in the L50 group (81.8%) (p=0.025), The average blood pressure reductions were: in sSBP (P/I-L50 = -2.4 mmHg; Cl: 6.2; 1.3) and sDBP (P/I-L50 = -2.0 mmHg; Cl: -4.2; 0.2), The average night-time SEP decrease (ABPM) was significantly greater in the PII group (p=0.041). The tolerability was comparable between the two groups in terms of emergent adverse events related to treatment (12.4% for P/I patients and 8.4% for L50 patients). Laboratory evaluations did not show any significant variations. It was concluded the low-dose P/I combination had significantly higher responder and normalisation rates than L50. This study also confirmed the good tolerability of both treatments.