RESUMO
AIM: To compare hypotensive, metabolic, and endothelial effects of indapamide-retard and hydrochlorothiazide. MATERIAL AND METHODS: Patients (n=50) with essential hypertension were given either indapamide-retard (1.5 mg/day, n=25) or hydrochlorothiazide (25 mg/day, n=25) for 12 weeks. Dynamics of the following parameters were studied: blood pressure, blood lipids and glucose, total coronary risk, carotid artery intima-media thickness, reaction of brachial artery to endothelium-dependent and endothelium-independent stimuli registered by high resolution ultrasound. RESULTS: Indapamide-retard and hydrochlorothiazide demonstrated similar hypotensive efficacy. Indapamide-retard turned out to be metabolically neutral while in patients receiving hydrochlorothiazide we observed significant elevation of triglycerides (+15.3%, p<0.05) and glucose (+12.2%, p<0.05). This resulted in the lack of lowering of total coronary risk during treatment with hydrochlorothiazide. Significant intergroup differences were revealed in effects on endothelium-dependent vasodilation with tendency to improvement and to significant worsening (-17%, p<0.05) in indapamide and hydrochlorothiazide treated patients, respectively. CONCLUSION: Despite similar hypotensive efficacy there were significant differences in metabolic and endothelial effects of 2 diuretics in favor of indapamide. This could potentially matter for long term cardiovascular prognosis.
Assuntos
Anti-Hipertensivos/uso terapêutico , Glicemia/metabolismo , Endotélio Vascular/efeitos dos fármacos , Hidroclorotiazida/uso terapêutico , Hipertensão/tratamento farmacológico , Indapamida/uso terapêutico , Triglicerídeos/sangue , Idoso , Glicemia/efeitos dos fármacos , Pressão Sanguínea/efeitos dos fármacos , Artéria Braquial/diagnóstico por imagem , Artéria Braquial/efeitos dos fármacos , Artéria Braquial/fisiopatologia , Endotélio Vascular/fisiopatologia , Feminino , Seguimentos , Humanos , Hipertensão/sangue , Hipertensão/fisiopatologia , Masculino , Pessoa de Meia-Idade , Resultado do Tratamento , Ultrassonografia , Vasodilatação/efeitos dos fármacosRESUMO
The experiments on rats with model traumatic disease showed that melatonin administration produces a dose-dependent positive effect, decreasing the degree and duration of disturbances in platelet hemostasis.