PMID- 16723864
OWN - NLM
STAT- MEDLINE
DCOM- 20061026
LR  - 20131121
IS  - 0952-1178 (Print)
IS  - 0952-1178 (Linking)
VI  - 24
IP  - 3
DP  - 2006 May
TI  - Renal protection in diabetic patients: benefits of a first-line combination of 
      perindopril-indapamide (Preterax).
PG  - S9-12
AB  - Type 2 diabetes mellitus (T2DM) is often accompanied by high blood pressure (BP) 
      and the clustering of several cardiovascular risk factors, and is the most 
      frequent cause of end-stage renal disease. The stages of development of overt 
      nephropathy in T2DM patients range from an initial alteration in renal function 
      with an increased GFR, followed by the development of microalbuminuria and 
      macroalbuminuria or proteinuria, featuring an established diabetic nephropathy, 
      which eventually progresses to end-stage renal disease. Early intervention is 
      needed to prevent the development of diabetic nephropathy and requires effective 
      control of the different risk factors, and in particular high BP. In the initial 
      stages of the disease, strict BP control is crucial to prevent the development of 
      initial renal and vascular damage. Adequate BP control is particularly difficult 
      in T2DM patients and in most cases requires the use of combination therapy. 
      Preterax, a fixed-dose combination of perindopril 2 mg and indapamide 0.625 mg, 
      allows BP to be significantly reduced compared with conventional strategies; this 
      combination can be uptitrated to BiPreterax when further BP control is needed. In 
      the PREMIER study performed in T2DM over 12 months, the perindopril/indapamide 
      combination brought about, in addition to excellent BP control, a significant 
      reduction in urinary albumin excretion, compared with monotherapy with enalapril. 
      In more advanced degrees of renal damage, higher doses of the fixed combination 
      have to be considered. The pharmacological basis of the renoprotective effect of 
      perindopril/indapamide is the demonstration that this combination prevented 
      nephropathy as well as proteinuria in obese Zucker rats, independently of BP 
      control. Strict BP control from the initial stages of nephropathy together with 
      inhibition of the renin-angiotensin system is mandatory to prevent albuminuria. 
      The fixed combination of perindopril/indapamide can greatly help clinicians in 
      achieving the above goals, using Preterax in the early and BiPreterax in the late 
      stages of nephropathy.
FAU - Ruilope, Luis M
AU  - Ruilope LM
AD  - Hypertension Unit, Hospital 12 de Octubre, Madrid, Spain. ruilope@ad-hocbox.com
FAU - Segura, Julian
AU  - Segura J
LA  - eng
PT  - Journal Article
PT  - Review
PL  - England
TA  - J Hypertens Suppl
JT  - Journal of hypertension. Supplement : official journal of the International 
      Society of Hypertension
JID - 8501422
RN  - 0 (Antihypertensive Agents)
RN  - 0 (Drug Combinations)
RN  - 0 (indapamide, perindopril drug combination)
RN  - F089I0511L (Indapamide)
RN  - Y5GMK36KGY (Perindopril)
SB  - IM
MH  - Albuminuria/prevention & control
MH  - Antihypertensive Agents/*therapeutic use
MH  - Clinical Trials as Topic
MH  - Diabetes Mellitus, Type 2/*complications
MH  - Diabetic Nephropathies/*prevention & control
MH  - Drug Combinations
MH  - Humans
MH  - Hypertension/*drug therapy
MH  - Indapamide/*therapeutic use
MH  - Perindopril/*therapeutic use
RF  - 18
EDAT- 2006/05/26 09:00
MHDA- 2006/10/27 09:00
CRDT- 2006/05/26 09:00
PHST- 2006/05/26 09:00 [pubmed]
PHST- 2006/10/27 09:00 [medline]
PHST- 2006/05/26 09:00 [entrez]
AID - 00004872-200605003-00003 [pii]
AID - 10.1097/01.hjh.0000229463.32480.a1 [doi]
PST - ppublish
SO  - J Hypertens Suppl. 2006 May;24(3):S9-12. doi: 10.1097/01.hjh.0000229463.32480.a1.