Short‐term effects of perindopril‐amlodipine vs perindopril‐indapamide on blood pressure control in sub‐Saharan type 2 diabetic individuals newly diagnosed for hypertension: A double‐blinded randomized controlled trial

Abstract Poor blood pressure (BP) control contributes to complications in sub‐Saharan African (SSA) type 2 diabetic individuals. Experts have advocated the use of combination therapies for effective BP control in these patients. The suggested combinations should include a RAAS antagonist and either a CCB or a thiazide diuretic; however, their efficacy is yet to be established in SSA. We investigated the short‐term effects of two combination therapies on BP control in SSA type 2 diabetic individuals. This was a double‐blinded randomized controlled trial conducted at the Yaoundé Central Hospital (Cameroon) from October 2016 to May 2017. We included type 2 diabetic patients, newly diagnosed for hypertension. After baseline assessment and 24‐hour ABPM, participants were allocated to receive either a fixed combination of perindopril + amlodipine or perindopril + indapamide for 42 days. Data analyses followed the intention‐to‐treat principle. We included fifteen participants (8 being females) in each group. Both combinations provided good circadian BP control after 6 weeks with similar efficacy. Twenty‐four‐hour SBP dropped from 144 to 145 mm Hg vs 128 to 126 mm Hg with perindopril‐amlodipine and perindopril‐indapamide, respectively ( P  = 0.003 for both groups). Twenty‐four‐hour DBP dropped from 85 to 78 mm Hg ( P  = 0.013) vs 89 to 79 mm Hg ( P  = 0.006) in the same respective groups. No significant adverse effect was reported. A fixed initial combination of perindopril‐amlodipine or perindopril‐indapamide achieved similar effective BP control after 6 weeks in SSA type 2 diabetic individuals with newly diagnosed hypertension. Therefore, these combinations can be used interchangeably in this indication.