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Effect of Low-Dose Perindopril/Indapamide on Albuminuria in Diabetes: Preterax in Albuminuria Regression: PREMIER

ABSTRACT—Microalbuminuria in diabetes is a risk factor for early death and an indicator for aggressive blood pressure (BP) lowering. We compared a combination of 2 mg perindopril/0.625 mg indapamide with enalapril monotherapy on albumin excretion rate (AER) in patients with type 2 diabetes, albuminu... Full description

Journal Title: Hypertension 2003, Vol.41 (5), p.1063-1071
Main Author: Mogensen, Carl Erik
Other Authors: Viberti, Giancarlo , Halimi, Serge , Ritz, Eberhard , Ruilope, Luis , Jermendy, Gyorgy , Widimsky, Jiri , Sareli, Pinchas , Taton, Jan , Rull, Juan , Erdogan, Gurbuz , De Leeuw, Pieter W , Ribeiro, Arthur , Sanchez, Ramiro , Mechmeche, Rachid , Nolan, John , Sirotiakova, Jana , Hamani, Ahmed , Scheen, Andre , Hess, Bernhard , Luger, Anton , Thomas, Stephen M
Format: Electronic Article Electronic Article
Language: English
Subjects:
Adult
Aged
albuminuria
Albuminuria - drug therapy
Albuminuria - etiology
Albuminuria - urine
Albuminuria/drug therapy/etiology/urine
angiotensin-converting enzyme
Antihypertensive agents
Antihypertensive Agents - adverse effects
Antihypertensive Agents - therapeutic use
Antihypertensive Agents/adverse effects/therapeutic use
Biological and medical sciences
Blood Pressure - drug effects
Cardiovascular & respiratory systems
Cardiovascular system
Cough - chemically induced
diabetes mellitus
Diabetes Mellitus, Type 2 - complications
Diabetes Mellitus, Type 2 - physiopathology
Diabetes Mellitus, Type 2/complications/physiopathology
Dizziness - chemically induced
Dose-Response Relationship, Drug
Double-Blind Method
Drug Therapy, Combination
Enalapril - adverse effects
Enalapril - therapeutic use
Enalapril/adverse effects/therapeutic use
Female
Follow-Up Studies
Human health sciences
Humans
hypertension, renal
Indapamide - adverse effects
Indapamide - therapeutic use
Indapamide/adverse effects/therapeutic use
Male
Medical sciences
microalbuminuria
Middle Aged
Perindopril - adverse effects
Perindopril - therapeutic use
Perindopril/adverse effects/therapeutic use
Pharmacie, pharmacologie & toxicologie
Pharmacology. Drug treatments
Pharmacy, pharmacology & toxicology
Sciences de la santé humaine
Systèmes cardiovasculaire & respiratoire
Treatment Outcome
Publisher: Philadelphia, PA: Am Heart Assoc
ID: ISSN: 0194-911X
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recordid: cdi_liege_orbi_v2_oai_orbi_ulg_ac_be_2268_2077
title: Effect of Low-Dose Perindopril/Indapamide on Albuminuria in Diabetes: Preterax in Albuminuria Regression: PREMIER
format: Article
creator:
  • Mogensen, Carl Erik
  • Viberti, Giancarlo
  • Halimi, Serge
  • Ritz, Eberhard
  • Ruilope, Luis
  • Jermendy, Gyorgy
  • Widimsky, Jiri
  • Sareli, Pinchas
  • Taton, Jan
  • Rull, Juan
  • Erdogan, Gurbuz
  • De Leeuw, Pieter W
  • Ribeiro, Arthur
  • Sanchez, Ramiro
  • Mechmeche, Rachid
  • Nolan, John
  • Sirotiakova, Jana
  • Hamani, Ahmed
  • Scheen, Andre
  • Hess, Bernhard
  • Luger, Anton
  • Thomas, Stephen M
subjects:
  • Adult
  • Aged
  • albuminuria
  • Albuminuria - drug therapy
  • Albuminuria - etiology
  • Albuminuria - urine
  • Albuminuria/drug therapy/etiology/urine
  • angiotensin-converting enzyme
  • Antihypertensive agents
  • Antihypertensive Agents - adverse effects
  • Antihypertensive Agents - therapeutic use
  • Antihypertensive Agents/adverse effects/therapeutic use
  • Biological and medical sciences
  • Blood Pressure - drug effects
  • Cardiovascular & respiratory systems
  • Cardiovascular system
  • Cough - chemically induced
  • diabetes mellitus
  • Diabetes Mellitus, Type 2 - complications
  • Diabetes Mellitus, Type 2 - physiopathology
  • Diabetes Mellitus, Type 2/complications/physiopathology
  • Dizziness - chemically induced
  • Dose-Response Relationship, Drug
  • Double-Blind Method
  • Drug Therapy, Combination
  • Enalapril - adverse effects
  • Enalapril - therapeutic use
  • Enalapril/adverse effects/therapeutic use
  • Female
  • Follow-Up Studies
  • Human health sciences
  • Humans
  • hypertension, renal
  • Indapamide - adverse effects
  • Indapamide - therapeutic use
  • Indapamide/adverse effects/therapeutic use
  • Male
  • Medical sciences
  • microalbuminuria
  • Middle Aged
  • Perindopril - adverse effects
  • Perindopril - therapeutic use
  • Perindopril/adverse effects/therapeutic use
  • Pharmacie, pharmacologie & toxicologie
  • Pharmacology. Drug treatments
  • Pharmacy, pharmacology & toxicology
  • Sciences de la santé humaine
  • Systèmes cardiovasculaire & respiratoire
  • Treatment Outcome
ispartof: Hypertension, 2003, Vol.41 (5), p.1063-1071
description: ABSTRACT—Microalbuminuria in diabetes is a risk factor for early death and an indicator for aggressive blood pressure (BP) lowering. We compared a combination of 2 mg perindopril/0.625 mg indapamide with enalapril monotherapy on albumin excretion rate (AER) in patients with type 2 diabetes, albuminuria, and hypertension in a 12-month, randomized, double-blind, parallel-group international multicenter study. Four hundred eighty-one patients with type 2 diabetes and hypertension (systolic BP ≥140 mm Hg,
language: eng
source:
identifier: ISSN: 0194-911X
fulltext: no_fulltext
issn:
  • 0194-911X
  • 1524-4563
  • 1524-4563
url: Link


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titleEffect of Low-Dose Perindopril/Indapamide on Albuminuria in Diabetes: Preterax in Albuminuria Regression: PREMIER
creatorMogensen, Carl Erik ; Viberti, Giancarlo ; Halimi, Serge ; Ritz, Eberhard ; Ruilope, Luis ; Jermendy, Gyorgy ; Widimsky, Jiri ; Sareli, Pinchas ; Taton, Jan ; Rull, Juan ; Erdogan, Gurbuz ; De Leeuw, Pieter W ; Ribeiro, Arthur ; Sanchez, Ramiro ; Mechmeche, Rachid ; Nolan, John ; Sirotiakova, Jana ; Hamani, Ahmed ; Scheen, Andre ; Hess, Bernhard ; Luger, Anton ; Thomas, Stephen M
creatorcontribMogensen, Carl Erik ; Viberti, Giancarlo ; Halimi, Serge ; Ritz, Eberhard ; Ruilope, Luis ; Jermendy, Gyorgy ; Widimsky, Jiri ; Sareli, Pinchas ; Taton, Jan ; Rull, Juan ; Erdogan, Gurbuz ; De Leeuw, Pieter W ; Ribeiro, Arthur ; Sanchez, Ramiro ; Mechmeche, Rachid ; Nolan, John ; Sirotiakova, Jana ; Hamani, Ahmed ; Scheen, Andre ; Hess, Bernhard ; Luger, Anton ; Thomas, Stephen M ; Preterax in Albuminuria Regression (PREMIER) Study Group
descriptionABSTRACT—Microalbuminuria in diabetes is a risk factor for early death and an indicator for aggressive blood pressure (BP) lowering. We compared a combination of 2 mg perindopril/0.625 mg indapamide with enalapril monotherapy on albumin excretion rate (AER) in patients with type 2 diabetes, albuminuria, and hypertension in a 12-month, randomized, double-blind, parallel-group international multicenter study. Four hundred eighty-one patients with type 2 diabetes and hypertension (systolic BP ≥140 mm Hg, <180 mm Hg, diastolic BP <110 mm Hg) were randomly assigned (age 59±9 years, 77% previously treated for hypertension). Results from 457 patients (intention-to-treat analysis) were available. After a 4-week placebo period, patients with albuminuria >20 and <500 μg/min were randomly assigned to a combination of 2 mg perindopril/0.625 mg indapamide or to 10 mg daily enalapril. After week 12, doses were adjusted on the basis of BP to a maximum of 8 mg perindopril/2.5 mg indapamide or 40 mg enalapril. The main outcome measures were overnight AER and supine BP. Both treatments reduced BP. Perindopril/indapamide treatment resulted in a statistically significant higher fall in both BP (−3.0 [95% CI −5.6, −0.4], P =0.012; systolic BP −1.5 [95% CI −3.0, −0.1] diastolic BP P =0.019) and AER −42% (95% CI −50%, −33%) versus −27% (95% CI −37%, −16%) with enalapril. The greater AER reduction remained significant after adjustment for mean BP. Adverse events were similar in the 2 groups. Thus, first-line treatment with low-dose combination perindopril/indapamide induces a greater decrease in albuminuria than enalapril, partially independent of BP reduction. A BP-independent effect of the combination may increase renal protection.
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1ISSN: 1524-4563
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3DOI: 10.1161/01.HYP.0000064943.51878.58
4PMID: 12654706
5CODEN: HPRTDN
languageeng
publisherPhiladelphia, PA: Am Heart Assoc
subjectAdult ; Aged ; albuminuria ; Albuminuria - drug therapy ; Albuminuria - etiology ; Albuminuria - urine ; Albuminuria/drug therapy/etiology/urine ; angiotensin-converting enzyme ; Antihypertensive agents ; Antihypertensive Agents - adverse effects ; Antihypertensive Agents - therapeutic use ; Antihypertensive Agents/adverse effects/therapeutic use ; Biological and medical sciences ; Blood Pressure - drug effects ; Cardiovascular & respiratory systems ; Cardiovascular system ; Cough - chemically induced ; diabetes mellitus ; Diabetes Mellitus, Type 2 - complications ; Diabetes Mellitus, Type 2 - physiopathology ; Diabetes Mellitus, Type 2/complications/physiopathology ; Dizziness - chemically induced ; Dose-Response Relationship, Drug ; Double-Blind Method ; Drug Therapy, Combination ; Enalapril - adverse effects ; Enalapril - therapeutic use ; Enalapril/adverse effects/therapeutic use ; Female ; Follow-Up Studies ; Human health sciences ; Humans ; hypertension, renal ; Indapamide - adverse effects ; Indapamide - therapeutic use ; Indapamide/adverse effects/therapeutic use ; Male ; Medical sciences ; microalbuminuria ; Middle Aged ; Perindopril - adverse effects ; Perindopril - therapeutic use ; Perindopril/adverse effects/therapeutic use ; Pharmacie, pharmacologie & toxicologie ; Pharmacology. Drug treatments ; Pharmacy, pharmacology & toxicology ; Sciences de la santé humaine ; Systèmes cardiovasculaire & respiratoire ; Treatment Outcome
ispartofHypertension, 2003, Vol.41 (5), p.1063-1071
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0Mogensen, Carl Erik
1Viberti, Giancarlo
2Halimi, Serge
3Ritz, Eberhard
4Ruilope, Luis
5Jermendy, Gyorgy
6Widimsky, Jiri
7Sareli, Pinchas
8Taton, Jan
9Rull, Juan
10Erdogan, Gurbuz
11De Leeuw, Pieter W
12Ribeiro, Arthur
13Sanchez, Ramiro
14Mechmeche, Rachid
15Nolan, John
16Sirotiakova, Jana
17Hamani, Ahmed
18Scheen, Andre
19Hess, Bernhard
20Luger, Anton
21Thomas, Stephen M
22Preterax in Albuminuria Regression (PREMIER) Study Group
title
0Effect of Low-Dose Perindopril/Indapamide on Albuminuria in Diabetes: Preterax in Albuminuria Regression: PREMIER
1Hypertension
addtitleHypertension
descriptionABSTRACT—Microalbuminuria in diabetes is a risk factor for early death and an indicator for aggressive blood pressure (BP) lowering. We compared a combination of 2 mg perindopril/0.625 mg indapamide with enalapril monotherapy on albumin excretion rate (AER) in patients with type 2 diabetes, albuminuria, and hypertension in a 12-month, randomized, double-blind, parallel-group international multicenter study. Four hundred eighty-one patients with type 2 diabetes and hypertension (systolic BP ≥140 mm Hg, <180 mm Hg, diastolic BP <110 mm Hg) were randomly assigned (age 59±9 years, 77% previously treated for hypertension). Results from 457 patients (intention-to-treat analysis) were available. After a 4-week placebo period, patients with albuminuria >20 and <500 μg/min were randomly assigned to a combination of 2 mg perindopril/0.625 mg indapamide or to 10 mg daily enalapril. After week 12, doses were adjusted on the basis of BP to a maximum of 8 mg perindopril/2.5 mg indapamide or 40 mg enalapril. The main outcome measures were overnight AER and supine BP. Both treatments reduced BP. Perindopril/indapamide treatment resulted in a statistically significant higher fall in both BP (−3.0 [95% CI −5.6, −0.4], P =0.012; systolic BP −1.5 [95% CI −3.0, −0.1] diastolic BP P =0.019) and AER −42% (95% CI −50%, −33%) versus −27% (95% CI −37%, −16%) with enalapril. The greater AER reduction remained significant after adjustment for mean BP. Adverse events were similar in the 2 groups. Thus, first-line treatment with low-dose combination perindopril/indapamide induces a greater decrease in albuminuria than enalapril, partially independent of BP reduction. A BP-independent effect of the combination may increase renal protection.
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1Aged
2albuminuria
3Albuminuria - drug therapy
4Albuminuria - etiology
5Albuminuria - urine
6Albuminuria/drug therapy/etiology/urine
7angiotensin-converting enzyme
8Antihypertensive agents
9Antihypertensive Agents - adverse effects
10Antihypertensive Agents - therapeutic use
11Antihypertensive Agents/adverse effects/therapeutic use
12Biological and medical sciences
13Blood Pressure - drug effects
14Cardiovascular & respiratory systems
15Cardiovascular system
16Cough - chemically induced
17diabetes mellitus
18Diabetes Mellitus, Type 2 - complications
19Diabetes Mellitus, Type 2 - physiopathology
20Diabetes Mellitus, Type 2/complications/physiopathology
21Dizziness - chemically induced
22Dose-Response Relationship, Drug
23Double-Blind Method
24Drug Therapy, Combination
25Enalapril - adverse effects
26Enalapril - therapeutic use
27Enalapril/adverse effects/therapeutic use
28Female
29Follow-Up Studies
30Human health sciences
31Humans
32hypertension, renal
33Indapamide - adverse effects
34Indapamide - therapeutic use
35Indapamide/adverse effects/therapeutic use
36Male
37Medical sciences
38microalbuminuria
39Middle Aged
40Perindopril - adverse effects
41Perindopril - therapeutic use
42Perindopril/adverse effects/therapeutic use
43Pharmacie, pharmacologie & toxicologie
44Pharmacology. Drug treatments
45Pharmacy, pharmacology & toxicology
46Sciences de la santé humaine
47Systèmes cardiovasculaire & respiratoire
48Treatment Outcome
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1Viberti, Giancarlo
2Halimi, Serge
3Ritz, Eberhard
4Ruilope, Luis
5Jermendy, Gyorgy
6Widimsky, Jiri
7Sareli, Pinchas
8Taton, Jan
9Rull, Juan
10Erdogan, Gurbuz
11De Leeuw, Pieter W
12Ribeiro, Arthur
13Sanchez, Ramiro
14Mechmeche, Rachid
15Nolan, John
16Sirotiakova, Jana
17Hamani, Ahmed
18Scheen, Andre
19Hess, Bernhard
20Luger, Anton
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titleEffect of Low-Dose Perindopril/Indapamide on Albuminuria in Diabetes: Preterax in Albuminuria Regression: PREMIER
authorMogensen, Carl Erik ; Viberti, Giancarlo ; Halimi, Serge ; Ritz, Eberhard ; Ruilope, Luis ; Jermendy, Gyorgy ; Widimsky, Jiri ; Sareli, Pinchas ; Taton, Jan ; Rull, Juan ; Erdogan, Gurbuz ; De Leeuw, Pieter W ; Ribeiro, Arthur ; Sanchez, Ramiro ; Mechmeche, Rachid ; Nolan, John ; Sirotiakova, Jana ; Hamani, Ahmed ; Scheen, Andre ; Hess, Bernhard ; Luger, Anton ; Thomas, Stephen M
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1Aged
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3Albuminuria - drug therapy
4Albuminuria - etiology
5Albuminuria - urine
6Albuminuria/drug therapy/etiology/urine
7angiotensin-converting enzyme
8Antihypertensive agents
9Antihypertensive Agents - adverse effects
10Antihypertensive Agents - therapeutic use
11Antihypertensive Agents/adverse effects/therapeutic use
12Biological and medical sciences
13Blood Pressure - drug effects
14Cardiovascular & respiratory systems
15Cardiovascular system
16Cough - chemically induced
17diabetes mellitus
18Diabetes Mellitus, Type 2 - complications
19Diabetes Mellitus, Type 2 - physiopathology
20Diabetes Mellitus, Type 2/complications/physiopathology
21Dizziness - chemically induced
22Dose-Response Relationship, Drug
23Double-Blind Method
24Drug Therapy, Combination
25Enalapril - adverse effects
26Enalapril - therapeutic use
27Enalapril/adverse effects/therapeutic use
28Female
29Follow-Up Studies
30Human health sciences
31Humans
32hypertension, renal
33Indapamide - adverse effects
34Indapamide - therapeutic use
35Indapamide/adverse effects/therapeutic use
36Male
37Medical sciences
38microalbuminuria
39Middle Aged
40Perindopril - adverse effects
41Perindopril - therapeutic use
42Perindopril/adverse effects/therapeutic use
43Pharmacie, pharmacologie & toxicologie
44Pharmacology. Drug treatments
45Pharmacy, pharmacology & toxicology
46Sciences de la santé humaine
47Systèmes cardiovasculaire & respiratoire
48Treatment Outcome
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8Taton, Jan
9Rull, Juan
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11De Leeuw, Pieter W
12Ribeiro, Arthur
13Sanchez, Ramiro
14Mechmeche, Rachid
15Nolan, John
16Sirotiakova, Jana
17Hamani, Ahmed
18Scheen, Andre
19Hess, Bernhard
20Luger, Anton
21Thomas, Stephen M
22Preterax in Albuminuria Regression (PREMIER) Study Group
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abstractABSTRACT—Microalbuminuria in diabetes is a risk factor for early death and an indicator for aggressive blood pressure (BP) lowering. We compared a combination of 2 mg perindopril/0.625 mg indapamide with enalapril monotherapy on albumin excretion rate (AER) in patients with type 2 diabetes, albuminuria, and hypertension in a 12-month, randomized, double-blind, parallel-group international multicenter study. Four hundred eighty-one patients with type 2 diabetes and hypertension (systolic BP ≥140 mm Hg, <180 mm Hg, diastolic BP <110 mm Hg) were randomly assigned (age 59±9 years, 77% previously treated for hypertension). Results from 457 patients (intention-to-treat analysis) were available. After a 4-week placebo period, patients with albuminuria >20 and <500 μg/min were randomly assigned to a combination of 2 mg perindopril/0.625 mg indapamide or to 10 mg daily enalapril. After week 12, doses were adjusted on the basis of BP to a maximum of 8 mg perindopril/2.5 mg indapamide or 40 mg enalapril. The main outcome measures were overnight AER and supine BP. Both treatments reduced BP. Perindopril/indapamide treatment resulted in a statistically significant higher fall in both BP (−3.0 [95% CI −5.6, −0.4], P =0.012; systolic BP −1.5 [95% CI −3.0, −0.1] diastolic BP P =0.019) and AER −42% (95% CI −50%, −33%) versus −27% (95% CI −37%, −16%) with enalapril. The greater AER reduction remained significant after adjustment for mean BP. Adverse events were similar in the 2 groups. Thus, first-line treatment with low-dose combination perindopril/indapamide induces a greater decrease in albuminuria than enalapril, partially independent of BP reduction. A BP-independent effect of the combination may increase renal protection.
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