Document Detail

Indapamide SR versus candesartan and amlodipine in hypertension: the X-CELLENT Study.
MedLine Citation:
PMID:  16461202     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Reducing systolic blood pressure (BP) is of major benefit to patients with isolated systolic hypertension, but lowering normal diastolic BP may be harmful in terms of cardiovascular risk. Effects of different drugs on systolic BP, diastolic BP, and pulse pressure are therefore of interest.
METHODS: The NatriliX SR versus CandEsartan and amLodipine in the reduction of systoLic blood prEssure in hyperteNsive patienTs study (X-CELLENT) was a randomized, double-blind, placebo-controlled study comparing the effects of three drugs on these BP components. Patients with systolic-diastolic or isolated systolic hypertension (n = 1758) received indapamide (1.5 mg) sustained release (SR), candesartan (8 mg), amlodipine (5 mg), or placebo once daily for 12 weeks.
RESULTS: Compared to placebo all active treatments reduced all BP components significantly (P < .001). For the patients with isolated systolic hypertension (n = 388), the three treatments significantly reduced systolic BP, but only indapamide SR did not change diastolic BP and thus reduced pulse pressure significantly relative to placebo (P = .005). In an ancillary study using ambulatory BP monitoring (n = 576), all three treatments significantly reduced BP components during 24 h relative to placebo. Changes in systolic BP and pulse pressure were similar with the three treatments, but the reduction in diastolic BP was significantly smaller, and therefore more favorable, with indapamide SR compared with candesartan (P = .039). In patients with isolated systolic hypertension (n = 106), indapamide SR reduced 24-h systolic BP significantly more than amlodipine (P = .037), and only indapamide SR reduced 24-h pulse pressure significantly relative to placebo (P = .03). All three drugs were well tolerated.
CONCLUSIONS: This distinctive BP-lowering profile of indapamide SR seems highly beneficial when compared to the either of candesartan or amlodipine.
Gerard London; Rolland Schmieder; Carlos Calvo; Rolland Asmar
Publication Detail:
Type:  Journal Article; Multicenter Study; Randomized Controlled Trial    
Journal Detail:
Title:  American journal of hypertension     Volume:  19     ISSN:  0895-7061     ISO Abbreviation:  Am. J. Hypertens.     Publication Date:  2006 Jan 
Date Detail:
Created Date:  2006-02-07     Completed Date:  2006-05-11     Revised Date:  2013-05-28    
Medline Journal Info:
Nlm Unique ID:  8803676     Medline TA:  Am J Hypertens     Country:  United States    
Other Details:
Languages:  eng     Pagination:  113-21     Citation Subset:  IM    
Service de Néphrologie et d'Hémodialyse, Centre Hospitalier F.H. Manhès, 8 rue Roger Clavier, Fleury Merogis, Ste Geneviève des Bois 91712, France.
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MeSH Terms
Aged, 80 and over
Amlodipine / adverse effects,  pharmacology,  therapeutic use*
Angiotensin II Type 1 Receptor Blockers / adverse effects,  pharmacology,  therapeutic use
Antihypertensive Agents / adverse effects,  pharmacology,  therapeutic use*
Benzimidazoles / adverse effects,  pharmacology,  therapeutic use*
Blood Pressure / drug effects
Calcium Channel Blockers / adverse effects,  pharmacology,  therapeutic use
Diastole / drug effects,  physiology
Double-Blind Method
Hemodynamics / drug effects
Hypertension / drug therapy*,  physiopathology
Indapamide / adverse effects,  pharmacology,  therapeutic use*
Middle Aged
Sodium / pharmacology
Sodium Chloride Symporter Inhibitors / adverse effects,  pharmacology,  therapeutic use
Systole / drug effects,  physiology
Tetrazoles / adverse effects,  pharmacology,  therapeutic use*
Reg. No./Substance:
0/Angiotensin II Type 1 Receptor Blockers; 0/Antihypertensive Agents; 0/Benzimidazoles; 0/Calcium Channel Blockers; 0/Sodium Chloride Symporter Inhibitors; 0/Tetrazoles; 26807-65-8/Indapamide; 7440-23-5/Sodium; 88150-42-9/Amlodipine; S8Q36MD2XX/candesartan
Comment In:
Am J Hypertens. 2006 Jan;19(1):8-9   [PMID:  16461182 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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