LAUSR

Objectives: our goal was to evaluate the 6-week antihypertensive efficacy of perindopril-amlodipine versus perindopril-indapamide combinations. Methods: We performed a double-arm randomized controlled clinical trial in 30 type 2 diabetic patients with stable treatment for at least 3 months, with clinical grade 1 or 2 hypertension confirmed by outpatient blood pressure measurement and naïve any antihypertensive treatment. The intervention consisted of the daily administration of a tablet of perindopril 5 mg - amlodipine 5 mg or perindopril 5 mg - indapamide 1.25 mg for 42 days. At inclusion and on the 42nd day, the blood tests of creatinine, uric acid, potassium, alanine amino transferase were performed, as well as a 24-hour MAPA. After a week-long run-in-period, compliance assessment using Morisky's questionnaire, adverse events, blood pressure, and tablet dispensing were performed on day 1, day 14, day 28, and day 42. Results: We selected 30 patients of median age of 57 [52–63] years with a median duration of diabetes of 7 [2–10] years and an HbA1c level of 58 [50–64] mmol / mol or 7, 5%. Our study population comprised 96.7% of non-dippers. After the intervention, the clinical PAS was 128 [119–133] mmHg versus 124 [108–137] mmHg respectively in the groups perindopril-amlodipine (group A) and perindopril-indapamide (group B) (p = 0.88) while the clinical PAD was 72 [72–82] mmHg versus 78 [70–89] mmHg (p = 0.31) for groups A and B, respectively. The PAS for 24 hours was 128 [125–138] mmHg in group A versus 126 [116–137] mmHg (p = 0.17) in group B, the 24-hour PAD was 78 [73–83] mmHg in group A versus 79 [68–86] mmHg in group B (P = 0.05). Conclusion: Both associations have similar antihypertensive efficacy. However, there is a marginal beneficial effect on 24-hour DBP variation in favor of the perindopril-indapamide