Effects of a low dose of indapamide, a diuretic, given daily or every-other-day on blood pressure and metabolic parameters

To investigate the effects of the diuretic, indapamide, on blood pressure (BP) and metabolic parameters, thirty hypertensive patients were treated with 1 mg of indapamide either every day or every other day. BP, fasting plasma glucose, lipids, serum potassium and uric acid were determined at baseline and after 3 months of a stable regimen of the drug. At the termination of the study, 48-h ambulatory blood pressure monitoring (ABPM) was performed. Three patients received only indapamide, while other patients were treated in combination with additional antihypertensive medications. Patients treated with daily indapamide showed a BP reduction from 162+/-2.9/85+/-2.4 mmHg to 134+/-2.4/71+/-2.6 mmHg (p<0.001). The BP reduction was similar in those patients receiving the drug every other day (137+/-3.4/71+/-3.6 mmHg). While plasma lipids and serum potassium did not differ significantly with the intervention, uric acid increased significantly with daily treatment and normalized with every-other-day treatment. Glycosylated hemoglobin A(1c) (HbA(1c)) was not altered (5.6+/-0.1% vs. 5.4+/-0.2%), and did not differ between patients with and without diabetes mellitus. ABPM revealed an average 24-h BP of 134+/-3.3/75+/-1.7 mmHg on days in which patients received the medication and 139+/-4.9/78+/-2.6 mmHg on the intervening day without indapamide (no significant difference). These results suggest that a low dose of indapamide given every day or every other day is effective in lowering BP and does not result in metabolic derangements.