Combination therapy with angiotensin-converting enzyme inhibitors and indapamide impairs glucose tolerance in Chinese hypertensive patients

Figures & data

Table I. Baseline characteristics of patients enrolled.

	F/I group (n=62)	F group (n=62)	p-value
Male (%)^b	40.3	41.9	0.91
Age (years)^a	52±8	52±7	0.63
IGT (%)^b	37.1	33.9	0.80
MS (%)^b	56.5	53.2	0.85
BW (kg)^a	71.2± 11.3	72.3±10.2	0.57
BMI (kg/m^2)^a	27.1±2.9	27.3±3.0	0.70
WC (cm)^a	90.4±9.0	90.2±9.3	0.89
WHR^a	0.94±0.06	0.93±0.07	0.36
SBP (mmHg)^a	150±11	149±10	0.55
DBP (mmHg)^a	95±6	95±4	0.81
HR (beats/min)^a	78±9	77±11	0.67
Previous antihypertensive drug
Beta-blocker	2	1
Calcium-channel blocker	3	3
Clonidine	2	2

F/I, fosinopril/indapamide; F, fosinopril; IGT, impaired glucose tolerance; MS, metabolic syndrome; BW, body weight; BMI, body mass index; WC, waist circumferences; WHR, waist-hip ratio; SBP, systolic blood pressure; DBP, diastolic blood pressure;HR,heart rate. ^aMean±SD, ^bpercentage. Test statistics: unpaired t-test for continuous variables and χ² for categorical variables between the two groups.

Figure 1. Study design. F, fosinopril; I, indapamide; W, week; M, month.

Table II. Baseline characteristics of patients who completed 12–16 months follow-ups.

	F/I group (n=45)	F group (n=44)	p-value
Male (%)^b	17/37.8	20/45.5	0.64
Age (years old)^3	52±7	52±6	0.50
IGT (%)^b	16/35.6	15/34.1	0.92
MS (%)^b	26/57.8	24/54.5	0.87
BW (kg)^3	70.4±10.2	72.5±10.5	0.34
BMI (kg/m^2)^3	27.1±2.8	27.4±2.8	0.57
WC (cm)^1	90.3±8.2	90.2±9.2	0.95
WHR^1	0.93±0.05	0.93±0.07	0.91
SBP (mmHg)^3	150±11	148±11	0.44
DBP (mmHg)^3	95±6	95±4	0.73
HR (beats/min)^3	79±10	78±11	0.69

The abbreviations are the same as Table I. ³Mean±SD, ^bpercentage. Test statistics: unpaired t-test for continuous variables and χ² for categorical variables between the two groups.

Table III. Treatment outcomes of patients who completed the follow-ups (mean±SD).

	F/I group (n=45)	F group (n=44)
SBP (mmHg)
Baseline	150±11	148 ±11
End-point	117±11**	129 ±13**
DBP (mmHg)
Baseline	95±4	95±6
End-point	80±7**	83 ±8**
HR (beats/min)
Baseline	79±10	78±11
End-point	77 ±11	77±8
BW (kg)
Baseline	70.4±10.2	72.5±10.5
End-point	70.1±12.0	71.1 ±10.9**
BMI (kg/m^2)
Baseline	27.1±2.8	27.4±2.8
End-point	26.9±3.1	26.8±3.0**
WC (cm)
Baseline	90.3±8.2	90.2±9.2
End-point	89.5±9.1	88.9±9.0*
WHR
Baseline	0.931±0.053	0.932±0.072
End-point	0.935±0.061	0.928±0.072
FBG (mmol/1)
Baseline	5.1±0.6	5.1±0.5
End-point	5.3±0.9*	4.8±0.7**
0.5-h PBG (mmol/1)
Baseline	9.1±1.1	9.0±1.4
End-point	9.4±1.9	8.6±1.8
1-h PBG (mmol/1)
Baseline	9.2±2.3	9.3±1.9
End-point	8.7±2.5*	9.9±2.8
2-h PBG (mmol/1)
Baseline	7.2±1.7	7.2±1.6
End-point	7.7±1.8*	6.4±1.4**
3-h PBG (mmol/1)
Baseline	4.5±1.1	4.3±0.7
End-point	4.7±1.3	4.2±0.9
AUCG (h-mmol/1)
Baseline	22.1±3.5	21.8±3.8
End-point	23.3±4.7*	20.4±3.9**
ISI(composite)
Baseline^a	103.7±49.7	107.3±52.4
End-point^a	87.9±46.6*	117.7±54.3*
K (mmol/1)
Baseline	4.3±0.5	4.3±0.4
End-point	4.0±0.4**	4.2±0.3
UA (mmol/1)
Baseline	0.33±0.10	0.34±0.07
End-point	0.37±0.12**	0.29±0.08**

F/I, fosinopril/indapamide; F, fosinopril; SBP, systolic blood pressure; DBP, diastolic blood pressure;HR,heart rate; BW, body weight; BMI, body mass index; WC, waist circumferences; WHR, waist-hip ratio; FBG, fasting blood glucose; PBG, postprandial blood glucose; AUC_G, area under the curve of glucose; ISI, insulin sensitivity index; K, serum potassium; UA, serum uric acid. Test statistics: paired t-test was used for intra-group comparison, *p<0.05, **p<0.01.

Table IV. Difference between baseline and end-point of treatment outcomes [means (95% confidence interval)].

	F/I group (n=45)	F group (n=44)
BW (kg)	–0.3 (–1.1 to 0.5)	–1.5 (—2.3 to —0.6)*
BMI (kg/m^2)	–0.2 (–0.5 to 0.2)	–0.6 (—1.0 to —0.3)*
WC (cm)	–0.8 (–2.0 to 0.3)	–1.3 (–2.5 to 0.1)
WHR	0.004 (–0.006 to 0.013)	–0.004 (–0.013 to 0.004)
FBG (mmol/1)	0.3 (0.1 to 0.4)	–0.3 (—0.4 to —0.1)**
0.5–h PBG (mmol/1)	0.3 (–0.2 to 0.7)	–0.4 (—0.8 to 0.1)*
1–h PBG (mmol/1)	0.6 (–0.1 to 1.3)	–0.6 (—1.0 to —0.1)**
2–h PBG (mmol/1)	0.6 (0.1 to 1.1)	–0.8 (—1.1 to —0.4)**
3–h PBG (mmol/1)	0.2 (–0.2 to 0.6)	–0.1 (–0.3 to 0.2)
AUCG (h–mmol/1)	1.09 (–0.15 to 2.32)	–0.15 (—2.19 to 0.75)**
ISI(composite)	–15.0 (–1.0 to 29.0)	10.1 (0.2 to 20.4)**
K (mmol/1)	–0.3 (–0.5 to 0.1)	–0.1 (—0.2 to 0.1)*
UA (mmol/1)	0.04 (0.01 to 0.07)	–0.05 (—0.06 to 0.03)**

The abbreviations are the same as Table III. Test statistics: unpaired t-test for the difference comparison between the two groups, *p<0.05, **p<0.0l.

Table V. Clinical and laboratory data changes in 29 patients who converted from fosinopril+indapamide combination therapy to fosinopril alone.

Items	Baseline	End-point of fosinopril+indapamide combination therapy	End-point of fosinopril alone
Fosinopril (mg/day)^b		8.2	11.2
Indapamide (mg/day)^b		2.2
Sex (male/female)	13/16
Age^a	52±8
BW (kg)^a	72.9±10.6	72.9±11.4	72.2±10.9
BMI (kg/m^2)^a	27.5±2.8	27.5±3.0	27.4±2.8
WC (cm)^1	92.7±8.3	92.1±9.1	91.1 ±8.5
WHR^1	0.94±0.06	0.94±0.07	0.93±0.11
SBP (mmHg)^a	149±11	118±8**	125±ll**tt
DBP (mmHg)^a	96±5	80±7**	81 ±7**
HR (beats/min)^a	79 + 9	77 + 9	77 + 9
FBG (mmol/l)^a	5.0±0.6	5.5±1.0**	5.3±1.0*f
0.5-h PBG (mmol/l)^a	9.0±1.1	9.6±2.1	9.1±1.9f
1-h PBG (mmol/l)^a	9.1±1.8	10.0±3.0*	9.2±2.6f
2-h PBG (mmol/l)^a	6.7±1.5	7.5±2.0*	7.0±2.7f
3-h PBG (mmol/l)^a	4.4±0.9	4.8±1.4	4.7±1.1
ISI (composite)^3	104.2±48.3	88.6±47.4*	99.4±51.6
K (mmol/l)^a	4.4±0.5	4.1±0.4*	4.3±0.3f
UA (mmol/l)^a	0.32±0.11	0.38±0.14**	0.29±0.09*ft

The abbreviations are the same as Tables I and III. ^aMean±SD, ^bgeometric means. Test statistics: GLM repeated-measures analysis for intra-group comparison, compared with the baseline *p< 0.05, **p<0.0l; compared with fosinopril+indapamide combination therapy ^†p<0.05, ^††p<0.01.