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Long-term tolerance of perindopril in hypertensive patients with impaired renal function

par Dratwa, Max ;Sennesael, Jacques;Taillard, F.;Baguet, F.;Suc, Jean Michel;Lins, Robert;Lameire, Norbert
Référence Journal of cardiovascular pharmacology, 18, 7, page (S40-S44)
Publication Publié, 1991

Article révisé par les pairs

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Résumé :

Thirty-six hypertensive patients with impaired renal function entered a long-term study to assess the safety of perindopril. There were 28 men and 8 women of mean age 57.1 ± 2.0 years (mean ± SEM). The duration of documented hypertension was 7.3 ± 1.2 years. Perindopril was given orally in single daily doses. The initial dosage was chosen according to the degree of renal function impairment: 29 patients received 4 mg o.d. [creatinine clearance (CIcr), 42.2 ± 3.2 ml · min 1] and 7 patients received 2 mg o.d. (CIcr), 22.3 ± 3.1 ml · min 1). Patients in whom blood pressure was not controlled had their dose doubled and then, if necessary, an additional diuretic therapy was added at subsequent visits. Six patients were withdrawn for adverse events (myocardial infarction, pneumonia, leucopenia in a patient who had lupus, diabetes mellitus, skin rash, epigastric pain), two patients were withdrawn for poor compliance, and three for personal convenience. The mean duration of treatment was 10.2 months with a range of 3-12 months (excluding one patient who died from myocardial infarction in the first days of the study and was not included in the analysis). Systolic and diastolic blood pressure decreased significantly (from 170.5/100.6 ± 3.4/1.8 mm Hg to 151.8/88.8 ± 3.0/1.7 mm Hg, n = 35, p < 0.001). Baseline and final values of plasma creatinine (from 223.7 ± 22.7 to 234.7 ± 28.5 μmol/I), Clcr (42.5 ± 3.2 to 45.7 × 4.6 ml · min 1), and kalemia (from 4.4 ± 0.1 to 4.7 ± 0.1 mmol/L) were not statistically different. Proteinuria decreased significantly (from 1.88 ± 0.56 to 0.86 ± 0.23 g/24 h: p < 0.01). Only minor side effects were recorded. In this study perindopril was shown to be efficient and well tolerated in hypertensive patients with renal failure. © 1991 Raven Press, Ltd., New York.