Background: First line antihypertensive treatment's drugs have to be able to decrease the cardiovascular morbidity and mortality. This kind of efficacy of thiazides type diuretics were published earlier in several studies. The efficacy of indapamide was investigated in several studies, but there is no analysis which is including all of the indapamide-studies.
Objective: We conducted a meta-analysis of all relevant randomized-controlled-trials with indapamide. Efficacy of indapamide was analyzed in different cardiovascular and safety outcomes.
Methods: We searched the MEDLINE database 1995-2005 for indapamide-trials. Only double-blind, parallel-group design trials were involved. Both the fixed effect model and the random effect model were used for data synthesis, results were probed with Mantel-Hanzel test and inverse variance test.
Results: Data were combined from 9 trials that included 10 108 patients. Indapamide treatment of 48 patients with a history of stroke prevents another stroke (NNT = 47.8 95% CI 29.6-126.6). Data from 5 trials including 7085 patients show that indapamide is superior to placebo in reducing blood pressure, the differences are: 7.28 mm Hg (95% CI: 6.37-8.19) in systolic blood pressure and 3.50 mm Hg (95% CI 2.99-4.01) in diastolic blood pressure. Data from 5 trials including 2856 patients show that indapamide is superior to active controls in reducing systolic blood pressure, the difference is significant: 1.30 mm Hg (95% CI 0.28-2.31). The difference in diastolic blood pressure was not significant. Data of 505 patients show that indapamide reduced left ventricular mass index significantly more than enalapril 20 mg, the difference is 6.50 g/m(2) (95%CI: 0.81-12.19). Data of 6206 patients show that frequency of adverse drug reaction is similar in the indapamide and placebo groups (rr = 0.97 95%CI 0.76-1.22).
Conclusions: Indapamide is efficacious in prevention of further stroke, reduces effectively the blood pressure and the left ventricular mass index. Indapamide treatment is well tolerated.