Natrilix SR,one tablet daily, is the reference diuretic antihypertensive for all your hypertensive patients, including those at risk.

The new Natrilix Sustained Release formulation was developed in accordance with the most recent international scientific requirements in terms of dose-efficacy relationship and safety of use.(1,2) Natrilix SR is particularly distinctive due to its innovative formulation, allowing a reduction in dose with maintenance of antihypertensive efficacy, leading to an optimized efficacy-safety ratio.(3)

Its antihypertensive efficacy is stable over 24 hours and maintained over the long term. In addition, Natrilix SR is so far the only diuretic that fulfills the most rigorous criteria of the FDA in terms of assessment of antihypertensive efficacy, with excellent trough-to-peak ratios of 89% and 85% for SBP and DBP, respectively.(5)

Even in case of an occasional delay in intake, Natrilix SR has been shown to have a persistent effect until the 32nd hour after the last drug intake.(6)

Natrilix SR significantly reduces LVH

The LIVE (Left ventricular hypertrophy: Indapamide Versus Enalapril) trial, one of the most rigorous trials ever conducted in LVH, was the first prospective clinical trial to include all the design features recommended by Prof Devereux. LIVE demonstrated that Natrilix SR, one tablet daily, is significantly more effective than enalapril 20 mg daily in reducing LV mass index by acting directly on the cardiac wall thickness, while both treatments produced similar SBP and DBP reductions.(7,8)

Whatever the LVH type, LV mass index was significantly reduced by treatment with Natrilix SR, with a markedly stronger effect on the more serious concentric LVH, whereas LV mass index reduction was not significant in the enalapril group after 1 year of treatment in patients with concentric LVH.(9)

An international, randomized, double-blind study proved that Natrilix SR is as effective as amlodipine and significantly more effective than hydrochlorothiazide in reducing SBP in elderly hypertensive patients with ISH, with a better normalization rate.(4)


Moreover, Natrilix SR is particularly suited to fragile hypertensive patients with associated metabolic disorders.

Indeed, Natrilix SR has been proven to be metabolically neutral on both lipid and carbohydrate profiles over the long term.(3,11) In addition, Natrilix SR does not significantly influence electrolyte profiles: no long-term modification of average potassium, no significant variation in serum sodium level, and a very mild long-term influence on uric acid. The high level of safety of Natrilix SR in terms of renal function was also confirmed in LIVE, where urea and creatinine levels remained stable over the long term.(3)


For all these reasons, Natrilix SR was chosen from all antihypertensive agents as the reference drug in HYVET (HYpertension in the Very Elderly Trial), the first morbidity-mortality trial in very elderly hypertensives, to answer the question of whether treatment benefits exist in patients over the age of 80 years.(12,13)

1. The sixth report of the Joint National Committee on detection, evaluation, and treatment of high blood pressure (JNC-VI). Arch Intern Med. 1997;157:2413-2446.
   
   
2. 1999 World Health Organization-International Society of Hypertension Guidelines for the Management of Hypertension. J Hypertens. 1999;17:151-183.
   
   
3. Weidmann P. Drug Safety. 2001;24:1155-1165.
   
   
4. Emeriau JP, Knauf H, Pujadas JO, et al. J Hypertens. 2001;19:343-350.
   
   
5. Mallion JM, Asmar R, Ambrosioni E, et al. Arch Mal Coeur Vaiss. 1996;89:27-38.
   
   
6. Jaillon P, Asmar R, and the investigators of the 32-h ABPM Study. ESH. Milan 2001. Abstract.
   
   
7. Gosse P, Sheridan DJ, Zannad F, et al. J Hypertens. 2000;18:1465-1475.
   
   
8. Gosse P, Guez D, Guéret P, et al. J Hypertens. 1998;16:531-535.
   
   
9. Gosse P, Guéret P, Dubourg O, Sheridan DJ. J Hypertens. 2000;18(suppl 4):558.
   
   
10. Ambrosioni E, Safar M, Degaute JP, et al. J Hypertens. 1998;16:1677-1684.
    
    
11. Bulpitt C, Fletcher A, Beckett N, et al. Drugs Aging. 2001;18:151-164.
    
    
12. Duggan J. Drugs Aging. 2001;18:631-638.