Intraoperative management of potentially fatal arrhythmias after anesthesia induced by severe hypokalemia: A case report / 北京大学学报(医学版)

Severe hypokalemia is defined as the concentration of serum potassium lower than 2.5 mmol/L, which may lead to serious arrhythmias and cause mortality. We report an unusual case of potentially fatal ventricular arrhythmias induced by severe hypokalemia in a patient undergoing laparoscopic partial nephrectomy in Peking University Third Hospital due to irregular use of indapamide before operation. Indapamide is a sulfonamide diuretic with vasodilative and calcium antagonistic effects, which enhances sodium delivery to the renal distal tubules resulting in a dose-related increase in urinary potassium excretion and decreases serum potassium concentrations. The electrolyte disorder caused by the diuretic is more likely to occur in the elderly patients, especially those with malnutrition or long-term fasting. Hence, the serum potassium concentration of the patients under indapamide therapy, especially elderly patients, should be monitored carefully. Meanwhile, the potassium concentration measured by arterial blood gas analysis is different from that measured by venous blood or laboratory test. According to the previous research, the concentration of potassium in venous blood was slightly higher than that in arterial blood, and the difference value was 0.1-0.5 mmol/L. This error should be taken into account when rapid intravenous potassium supplementation or reduction of blood potassium level was carried out clinically. In the correction of severe hypokalemia, the standard approach often did not work well for treating severe hypokalemia. The tailored rapid potassium supplementation strategy shortened the time of hypokalemia and was a safe and better treatment option to remedy life-threatening arrhythmias caused by severe hypokalemia with a high success rate. Through the anesthesia management of this case, we conclude that for the elderly patients who take indapamide or other potassium excretion diuretics, the electrolyte concentration and the general volume state of the patients should be comprehensively measured and fully evaluated before operation. It may be necessary for us to reexamine the serum electrolyte concentration before anesthesia induction on the morning of surgery in patients with the history of hypokalemia. For severe hypokalemia detected after anesthesia, central venous cannulation access for individualized rapid potassium supplementation is an effective approach to reverse the life-threatening arrhythmias caused by severe hypokalemia and ensure the safety of the patients.

Thiazide and thiazide-like diuretics in nephrolithiasis / Diuréticos tiazídicos e tiazídicos-like na nefrolitíase

Abstract Thiazide and thiazide-like diuretics are widely used for the management of hypercalciuria among stone-forming patients. Although the effects of different thiazides should be relatively similar in terms of prevention of stone recurrence, their potency and side effects may differ. However, there is scarce data concerning the metabolic and bone effects of these agents among recurrent nephrolithiasis patients with hypercalciuria. The aim of this update article was to compare our experience in the use of thiazide and thiazide- like diuretics with that of the current literature, concerning their anticalciuric properties and consequent reduction of recurrent stone formation. Their impact on bone mass and potential side effects were also discussed.

Resumo Diuréticos tiazídicos e tiazídicos-like são amplamente usados para o tratamento da hipercalciúria em pacientes com formação de cálculos. Embora os efeitos dos diferentes tiazídicos devam ser relativamente semelhantes em termos de prevenção da recorrência do cálculo, sua potência e efeitos colaterais podem ser diferentes. No entanto, há poucos dados sobre os efeitos metabólicos e ósseos desses agentes em pacientes com nefrolitíase recorrente com hipercalciúria. O objetivo deste artigo de atualização foi comparar nossa experiência quanto ao uso de tiazídicos e tiazídicos-like com a publicada na literatura atual, no que diz respeito às suas propriedades anticalciúricas e consequente redução da formação de cálculos recorrentes. Discutimos também seu impacto na massa óssea e potenciais efeitos colaterais.

EXISTEM DIFERENÇAS ENTRE OS DIURÉTICOS TIAZÍDICOS? / ARE THERE ANY DIFFERENCES BETWEEN THIAZIDE DIURETICS?

Desenvolvidos em 1950, os diuréticos estão entre as drogas mais utilizadas no arsenal terapêutico clínico, principalmente na hipertensão arterial e nos quadros edematosos. O mecanismo de ação envolve a excreção renal de água, eletrólitos e diminuição da reabsorção de sódio em diferentes locais do néfron, com consequente aumento do sódio urinário e da água. Os diuréticos tiazídicos mais usados na prática clínica em pacientes hipertensos são: hidroclorotiazida (HCTZ), clortalidona (CTD) e indapamida (IDP). Em relação à potência anti-hipertensiva, a CTD é uma vez e meia a duas vezes mais potente que a hidroclorotiazida. HCTZ é menos potente do que qualquer outro anti-hipertensivo, incluindo inibidores da enzima de conversão da angiotensina, bloqueadores do receptor da angiotensina e antagonistas dos canais de cálcio. O IDP tem ação anti-hipertensiva devido aos seus efeitos no túbulo distal, inibindo a reabsorção do cloreto de sódio e tem efeitos mais intensos e sustentados na redução da pressão arterial. Os diuréticos tiazídicos são muito diferentes, tanto em níveis variados de redução da pressão arterial quanto em efeitos adversos, de modo que sua proteção contra danos em órgãos-alvo está relacionada ao efeito de classe

Developed in 1950, diuretics are among the most used drugs in the clinician's therapeutic arsenal, especially in arterial hypertension and edematous conditions. The mechanism of action involves the renal excretion of water, electrolytes, and decreasing the reabsorption of sodium in different locations of the nephron, with consequently an increase in urinary sodium and water. The most used thiazide diuretics in clinical practice in hypertensive patients are: hydrochlorothiazide (HCTZ), chlortalidone (CTD) and indapamide (IDP). Regarding the antihypertensive potency, CTD is one and a half to two times more potent than hydrochlorothiazide. HCTZ is less potent than any other antihypertensives including angiotensin converting enzyme inhibitors, angiotensin receptor blockers, and calcium channel antagonists. IDP has an antihypertensive action due to its effects on the distal contoured tubule, inhibiting sodium chloride reabsorption and has more intense and sustained effects in reducing blood pressure. Thiazide diuretics are very different, both in varying levels of blood pressure reduction and adverse effects, so their protection from target organ damage is related to the class effect

Study on Preparation Phase Identification and Release Rate in vitro of Inclusion Compound of Indapamide- β-cyclodextrin Inclusion Compound / 中国药房

OBJECTIVE： To establish a method for content determination of indapamide （IDP）-β-cyclodextrin （β-CD） inclusion compound， optimize the preparation technology， carry out phase identification and in vivo release study of it. METHODS： UV spectrophotometry was used to determine the content of IDP in IDP-β-CD inclusion compound. IDP-β-CD inclusion compound was prepared by the solution-stirring method and the preparation technology was optimized by the orthogonal experiment using inclusion rate as index. The inclusion rate and drug-loading rate were compared between different drying methods. Phase identification of IDP-β-CD inclusion compound was verified by IR and DSC. The cumulative release rate of inclusion compound was tested by in vitro experiment. RESULTS： The linear range of concentration of IDP was 2.0-14.0 μg/mL （r＝0.999 7）. The quantitative limit and detection limit were 0.204， 0.067 μg/mL， respectively. RSDs of precision， stability and repeatability tests were all less than 2％. The recoveries range was 98.8％-101.8％（RSD＝1.10％，n＝6）. The optimum technology conditions were as follows the molar ratio of β-CD to IDP was 3 ∶ 1， the inclusion time was 3 h， and the stirring speed was 300 r/min. Average inclusion rate of IDP-β-CD inclusion compound was 72.81％. IR and DSC analysis showed that IDP and β-CD formed inclusion compound through physical interaction. After spray drying， the inclusion rate and drug-loading rate of IDP-β-CD inclusion compound were （60.96±0.25）％ and （4.18±0.12）％. After freeze-drying， the inclusion rate and drug-loading rate of IDP-β-CD inclusion compound were （77.31±0.51）％ and （5.31±0.27）％. Accumulative release rates of IDP， IDP-β-CD inclusion compound （by freeze-drying and spray drying） were 37.2％， 42.5％ and 81.9％ within 12 h， respectively. Compared with IDP raw material， accumulative release rate of IDP-β-CD inclusion compound increased significantly after spray drying. CONCLUSIONS： Established method is simple and accurate. The optimal preparation technology of inclusion compound is stable and feasible. IDP-β-CD inclusion compound is prepared successfully. The inclusion compound prepared by spray drying shows higher release rate.

Cardiac arrhythmia triggered by diureticinduced hyponatremia

@#Diuretics have a long and distinguished history in the treatment of hypertension and heart failure. Clinical practice guidelines recommend that diuretics should be considered to be as suitable as other antihypertensive agents for the initiation and maintenance of antihypertensive treatment. However, diuretics may potentially cause electrolyte disturbances and metabolic side effects. Diuretic-induced hyponatremia is probably more prevalent than generally acknowledged. We present an unusual case of indapamide-induced hyponatremia and hypokalemia complicated by cardiac arrhythmia. The adverse drug reaction was reversible and non-life-threatening, but this case serves as a reminder that careful evaluation and constant monitoring are necessary when prescribing diuretics.

Curative effect of indapamide combined with amlodipine in the treatment of hypertension complicated with coronary heart disease / 中国基层医药

Objective To explore the clinical effect of indapamide combined with amlodipine in the treatment of hypertension complicated with coronary heart disease (CHD).Methods From January 2015 to January 2017,62 hypertension patients complicated with CHD in the First People's Hospital of Daishan County were selected in the research.The patients were randomly divided into two groups according to the digital table ,with 31 cases in each group.The observation group received indapamide combined with amlodipine therapy ,and the control group received nifedipine controlled release tablets .The curative effect was compared between the two groups .Results After treatment,the treatment effective rate of the observation group was 93.55%,the incidence rate of adverse reactions of the observation group was 9.68%,which of the control group were 83.87%,25.81%,respectively.The differences were significant in therapeutic effect ,total cholesterol ,angina frequency,triglycerides,systolic pressure,diastolic blood pressure between the two groups (χ2＝8.226,t＝8.226,6.223,7.112,5.012,5.348,all P＜0.05).Conclusion Amlodipine in combination with indapamide in the treatment of hypertension complicated with CHD can reduce blood pressure,better auxiliary lower total cholesterol and triglyceride levels ,avoid attack frequency of angina pectoris ,and with no increase in adverse drug reactions ,it has a certain clinical significance .

Simultaneous determination of indapamide, perindopril and perindoprilat in human plasma or whole blood by UPLC-MS/MS and its pharmacokinetic application / 药物分析学报

Simple and sensitive methods were developed for the determination of indapamide, perindopril and its active metabolite perindoprilat in human plasma or whole blood by hyphenated ultra-performance li-quid chromatography-mass spectrometry (UPLC-MS/MS). Indapamide-d3, perindopril-d4 and perindo-prilat-d4 were used as the internal standards. The separation was performed on a Thermo BDS Hypersil C18column (4.6 mm × 100 mm, 2.4 μm) for indapamide and perindopril simultaneously following a protein precipitation pretreatment of the biosamples. The separation of perindoprilat was achieved in-dependently on a phenomenex PFP column (4.6 mm × 150 mm, 5 μm). All the analytes were quantitated with positive electrospray ionization and multiple reactions monitoring mode. The assay exhibited a linear range of 1–250 ng/mL for indapamide, 0.4–100 ng/mL for perindopril and 0.2–20 ng/mL for peri-ndoprilat. The methods were fully validated to meet the requirements for bioassay in accuracy, precision, recovery, reproducibility, stabilities and matrix effects, and successfully applied to the pharmacokinetic study of perindopril tert-butylamine/indapamide compound tablets in Chinese healthy volunteers and the comparative pharmacokinetic study between plasma and whole blood.

Comparison of Therapeutic Efficacy and Safety of Indapamide Combined with 3 Anti-hypertension Drugs for Grade 2 Essential Hypertension / 中国药房

OBJECTIVE:To compare therapeutic efficacy and safety of indapamide separately combined with benazepril,irbe-sartan or amlodipine for grade 2 essential hypertension(EH). METHODS:A total of 150 patients with grade 2 EH were randomly divided into benazepril group(50 cases),irbesartan group(50 cases)and amlodipine group(50 cases). 3 groups were given Indap-amide tablet 2.5 mg orally,once a day. Benazepril group was additionally given Benazepril hydrochloride tablet 10 mg orally,once a day;irbesartan group was additionally given Irbesartan tablet 150 mg orally,once a day;amlodipine group was additionally giv-en Amlodipine tablet 5 mg orally,once a day. 3 groups were treated for 12 weeks. The levels of systolic pressure,diastolic pres-sure,heart rate,total cholesterol(TC),three triacylglycerol(TG)and serum potassium as well as the occurrence of ADR were ob-served in 3 groups before and after treatment. RESULTS:The total response rate of berazopril group,irbesartar group and a mloelip-ire group had no significant difference(90.0% vs. 88.0% vs. 92.0%,P>0.05). There were no statistical significances in the levels of systolic pressure,diastolic pressure,heart rate,TC,TG and serum potassium among 3 groups before treatment(P>0.05). Af-ter treatment,systolic pressure and diastolic pressure of 3 groups were significantly lower than before,with statistical significance (P0.05). There were no statistical significance in heart rate, TC,TG of 3 groups before and after treatment and the level of serum potassium in benazepril group and irbesartan group (P>0.05). After treatment,the level of serum potassium in amlodipine group was significantly lower than before,with statistical signifi-cance (P0.05). CONCLUSIONS:The indapamide separately combined with benazepril,irbesartan or amlodipine have similar therapeu-tic efficacy for grade 2 EH,but the safety of irbesartan is better than those of benazepril and amlodipine.

Influence of valsartan combined with indapamide on the UmAlb level and blood pressure in patients with hypertension and diabetes mellitus / 中国基层医药

Objective To study the influence of valsartan combined with indapamide on the UmAlb level and blood pressure in patients with hypertension and diabetes mellitus.Methods 90 patients with hypertension and diabetes mellitus were selected and randomly divided into three groups by number table.30 cases of the control group A were treated with indapamide,30 cases of the control group B were treated with valsartan,30 cases of the observa-tion group were treated with indapamide combined with valsartan.After treatment,the clinical parameters and effect of the three groups were compared.Results After treatment,the systolic blood pressure and diastolic blood pressure of the three groups were decreased(all P <0.05),and the observation group decreased obviously(all P <0.05).The total effective rate of the observation group was 96.7%,which was higher than 86.6% of the control group A and 83.3% of the control group B(χ2 =4.1 2,4.22,all P <0.05).Conclusion In the treatment of hypertension and diabetes,the antihypertensive effect of indapamide combined with valsartan is obvious and can protect the renal func-tion,which should be promoted in clinical use.

Preparation of indapamide sustained-release capsules and investigation of its release in vitro / 中国药学杂志

OBJECTIVE: To prepare indapamide sustained release capsules and investigate its release in vitro. METHODS: Blank pellets, hydrated magnesium silicate, hypromellose cellulose, triethyl citrate, Eudragit RL 100, Eudragit RS 100, Eudragit LS 55, etc, were used as materials to prepare indapamide sustained release capsules The content was determined by HPLC, and the effects of different solid weight gains of sustained release material on release of indapamide from capsules were evaluated by in vitro release test. RESULTS: The release in vitro of the sustained release pills met the requirements when the solid weight gain of the materials was 5.0% to 5.3%. CONCLUSION: The optimum preparation technique of indapamide sustained release capsules is established, which has guiding significance for the practical manufacture.

The clinical study on valsartan combined with indapamide in the treatment of hypertension / 中国医学装备

Objective: To explore the clinical effect of valsartan combined with indapamide in the treatment of hypertension. Methods: In our hospital in 2012 August ~ 2013 August treatment of 280 cases of hypertensive patients, all patients had drug withdrawal for 2 weeks. Were randomly divided into observation group 100 cases and control group 1, control group 2 of the 90 cases, control group 1 given valsartan, control group 2 given indapamide, the observation group were given valsartan combined with indapamide, were treated for 8 weeks. Results:three groups of patients before treatment, the blood pressure were not significantly different, after the treatment, the observation group decreased blood pressure was significantly higher than that in control group, the total efficiency had significant difference (x2=6.472, P<0.05). Conclusion:Valsartan combined with indapamide in the treatment of hypertension has fast acting, high curative effect, long duration, few adverse reactions, is the ideal choice for the treatment of hypertension, is worth the clinical promotion and application.

Development and Evaluation of Sustained Release Matrix Tablets of Indapamide using Methocel K15M CR.

In the present study an attempt has been taken to develop Indapamide sustained release matrix tablet using Methocel K15M CR by direct compression method. Various amount of polymer was used in the five proposed formulations (F-1to F-5) for the study of release rate retardant effect at 26.47%, 29.41%, 32.35%, 35.29% and 38.24% of total weight of tablet matrix respectively. Then the tablets were evaluated in terms of their physical parameters (weight variation, hardness, friability and thickness), drug content and in vitro release studies. All the formulations showed compliance with pharmacopoeial standards. The in vitro dissolution study were conducted using USP 30 dissolution apparatus type I (Basket method) in 900 ml phosphate buffer (pH 6.8) at 100 rpm for a total period of 24 hours. The release mechanisms were explored and explained by Zero order, Higuchi, First order and Korsmeyer-Peppas equations. Based on the dissolution data comparison with innovator brand formulation F-3 (32.35% Methocel K15M CR w/w) was found as the best formulation. The drug release profile of this formulation was well controlled and uniform throughout the dissolution studies. The drug release of formulation F-3 followed First Order kinetic model (r2 = 0.99) and the mechanism was found to be non- Fickian/anomalous according to Korsmeyer-Peppas equation.

The clinical efficacy and safety of indapamide combined with metoprolol in the treatment of hypertension patients with chronic heart failure / 中国基层医药

Objective To observe the effect and safety of metoprolol combined with indapamide in the treatment of hypertension patients with chronic heart failure (CHF).Methods 78 hypertension patients with CHF were given indapamide 2.5mg/d,metoprolol 6.25mg/d,1time/d,based on conventional anti-heart failure treatment,the double dose was given two weeks later.Then the dose was adjusted according to the patients' condition and the individual response.Blood pressure,heart rate and cardiac function were observed.Results Compared with before treatment,systolic blood pressure [(142.6 ±5.1)mm Hg vs (178.0 ±7.5) mm Hg],diastolic blood pressure[(91.3 ± 3.6)mm Hg vs (109.5 ± 4.2) mm Hg],heart rate [(76 ± 9) times/min vs (117 ± 11) times/min],LVEDVI [(133 ± 14)ml/m2 vs (164 ±21) ml/m2] and the LVESVI[(92 ± 10)ml/m2 vs (118 ± 17)ml/m2] were significantly reduced after treatment,and the differences were statistically significant (all P ＜ 0.05).Cardiac function was significantly improved,the total effective rate was 93.6％.Conclusion Metoprolol and indapamide combination therapy for hypertension patients with CHF has good efficacy,it is safe and worthy of clinical application.

Characterization and evaluation of the release kinetics of a model poorly water-soluble and low dose drug from matrix tablets composed of blends of swellable and erodible polymers: implications for controlled and complete release.

The specific aim of this study was to prepare sustained release matrix tablets containing indapamide as a low dose and low water solubility model drug. The matrix formers were composed of blends of hydroxypropyl methylcellulose as a swellable polymer and methyl cellulose as an erodible polymer. The matrix tablets were prepared by the direct compression technique and they have shown robust and acceptable physical properties with a content uniformity within the acceptable limits. Lactose and microcrystalline cellulose were investigated as additives to these matrices in order to adjust and modulate the release of the drug from the matrices to achieve a release profile similar to that obtained from the reference commercial product, Natrilix®. All matrix tablets prepared with these two additives have gave a release profile that is close to zero order kinetics, however, the matrix tablets prepared with lactose gave a release profile with closer resemblance to that of the reference product with a similarity factor (F2) of 86. This is attributed to the rapid water solubility of lactose which enhanced higher erosion of the tablets, and thus, higher dissolution and diffusion of the drug. Microcrystalline cellulose is a swellable polymer where it has resulted in delayed release of the drug with time as compared to the reference product. Investigation of the mechanism of release of the drug from the matrices indicated that erosion is the dominant mechanism of drug release from these matrices.

Relationship between the polymorphism of the AT2R gene 1675A/G and the effect of indapamide sustained release tablets in female hypertension patients / 中国综合临床

Objective To investigate the relationship of the1675A/G polymorphism of AT2 gene with the therapeutic effect of indapamide sustained release tablets in female patients with primary hypertension.Methods Two hundred and twenty female patients with primary hypertension were treated with Indapamide Sustained Release Tablets ( 1.5 mg · qd) for 8 weeks.The blood samples from the patients were collect to determine AT2 gene polymorphism by PCR combined with HRM and sequencing.Results Two hundred and five patients completed the test.In female patients,the therapeutic efficacy of indapamide sustained telease tablets among different AT2R genotypes( AA:70.6％,AG:71.6％,GG:71.4％ ) showed no significant difference ( x2=2.53,P=0.49 ),neither do the decline of BP after therapy ( F=0.39 and 0.19 respecrively,P ＞ 0.05).Conclusion The AT2 genotype was assumed to be not correlated to the blood pressure lowering response to Indapamide Sustained Release Tablets in female primary hypertension patients.

Influence of indapamide on pharmacokinetics of telmisartan in male and female rats / 中国药理学与毒理学杂志

AIM To study the influence of indapamide(Ind) on pharmacokinetics of telmisartan(Tel) and observe the difference between male and female rats. METHODS Wistar rats were divided into Tel and Tel+Ind groups, each group containing 8 female and 8 male rats, and were ig administered a single dose of either Tel 3.6 mg·kg-1 or Tel 3.6 mg·kg-1+Ind 0.135 mg·kg-1, respectively. Blood samples were collected at intervals over 96 h after administration. The Tel concentrations in plasma were determined by high performance liquid chromatography with fluorescence detector. The Tel concentration-time curves were simulated by 3p97 software and the pharmacokinetic parameters were calculated. RESULTS Whatever in female or male rats, there were no significant differences in the main pharmacokinetic parameters of Tel between Tel and Tel+Ind groups. However, females had higher values for area under the concentration-time curve and maximum plasma concentration than males, but lower values for total clearance in both Tel and Tel+Ind groups. CONCLUSION Ind has no significant influences on the pharmacokinetics of Tel. However, pharmacokinetics of Tel is significant different between male and female rats.

Telmisartan in Combination with Different Drugs for Mild to Moderate Essential Hypertension:Cost-Effectiveness Analysis / 中国药房

OBJECTIVE:To evaluate the cost-effectiveness of telmisartan in combination with different drugs in the trea-tment of mild to moderate essential hypertension.METHODS:A total of 60 patients were enrolled and randomized to Group A(telmisartan+felodipine),Group B(telmisartan+enalapril),or Group C(telmisartan+indapamide).A cost-effectiveness analysis of the three therapeutic schemes was conducted after 8-wk treatment.RESULTS:The effective rates of three Groups were 90%,85% and 95%,respectively;the total costs of three groups were 422.80,409.50 and 348.88 yuan,respectively,with Group C showing significant difference as compared with the other two groups(Group B and Group C)(P

Effect of Indapamide on the Rehabilitation of Cardiac Function in Patients with Primary Hypertension Disease / 中国康复理论与实践

@#ObjectiveTo observe the effect of Indapamide on the rehabilitation of cardiac function in patients with primary hypertension disease.Methods56 patients with primary hypertension disease were randomly divided into the Indapamide group and Hydrochlorothiazide group with 28 cases in each group, and treated with Indapamide and Hydrochlorothiazide respectively assisted with conventional non-drug treatment such as dietetic and weight control. The cardiac functions of patients in two groups were examined with echocardiography before and two months after treatment.ResultsAfter treatment, the left ventricular ejection fraction (LVEF) raised and relative wall thickness (RWT) declined in patients of two groups, but the effect of the Indapamide group was better than that of the Hydrochlorothiazide group ( P<0.05).ConclusionThe effect of Indapamide on cardiac function and structure is better than Hydrochlorothiazide.

Effects of valsartan and indapamide on plasma cytokines in essential hypertension / 中南大学学报(医学版)

Objective To investigate and compare the effect of valsartan and indapamide on inflammatory cytokines in hypertension. Methods Forty-one untreated patients with mild to moderate hypertension and 20 age- and sex-matched normotensives were enrolled in this study. Hypertensives were treated with indapamide 1.5 mg/d (n=20) or valsartan 80 mg/d (n=21) for 4 weeks, and blood samples for determining monocyte chemotactic protein-1 (MCP-1), macrophage inflammatory protein-1 (MIP-1α), sP-selectin, asymmetric dimethylarginin (ADMA), angiotensin Ⅱ (AngⅡ), and 6-keto-PGF1α were collected before the treatment and 4 weeks after the treatment. Results Hypertensives exhibited significantly higher blood pressure, as well as elevated plasma levels of MCP-1, MIP-1α, sP-selectin and serum level of ADMA compared with the normotensives. Nevertheless, there was no significant difference in serum 6-keto-PGF1α and AngⅡ between the hypertensives and the normotensives. After the treatment with indapamide or valsartan for 4 weeks, both the systolic and diastolic blood pressures, though still higher than those of the normotensives, decreased markedly. After the treatment with indapamide for 4 weeks, MCP-1, MIP-1α and sP-selectin slightly decreased, but not statistically significant (P＞0.05). Those cytokines decreased significantly after being treated with valsartan for 4 weeks [(19.16±3.11) pg/mL vs (16.08±2.67) pg/mL, P＜0.05; (27.74±8.36) pg/mL vs (17.64±7.59) pg/mL, P＜0.05; (2.67±3.18) pg/mL vs (6.15±2.94) pg/mL, P＜0.01]. In the 2 treatment groups, 6-keto-PGF1α markedly increased [(61.96±20.81) pg/mL vs (96.72±25.89) pg/mL, P＜0.05; (63.25±16.92) pg/mL vs (143.22±43.45) pg/mL, P＜0.01]; ADMA decreased significantly [(1.35±0.74) pg/mL vs (0.98±0.56) μmol/L, P＜0.05; (1.31±0.68) pg/mL vs (0.71±0.52) μmol/L, P＜0.01]. Though AngⅡ slightly increased, no statistical significance was found (P＞0.05). Conclusion The levels of MCP-1, MIP-1α, sP-selectin and ADMA were elevated in mild to moderate hypertensives. Valsartan and indapamide have similar blood pressure lowering effect. Valasartan exerts more significant effect on cytokines than indapamide does.

Antihypertensive effect of indapamide combined with enalapril on spontaneously hypertensive rats / 上海第二医科大学学报

Objective To observe the antihypertensive effect of indapamide combined with enalapril on spontaneously hypertensive rats(SHRs).Methods Forty SHRs were randomly divided into 4 groups: control,indapamide,enalapril,and indapamide+enalapril(n=10 in each group).Medicine in varied doses was given to rats by intragastric administration.Variations of weight,heart rate and blood pressure were measured. Results Varied doses of medicine did not exert significant effects to the weight and heart rate of SHRs during and after the administration.In indapamide+enalapril group,the pressure of SHRs was significantly decreased with varied doses compared to that before the administration(P