title: Ramipril/amlodipine single pill - effectiveness, tolerance and patient satisfaction with antihypertensive therapy in relation to nutritional status.
abstract: BACKGROUND
  Overweight and obesity decrease the effectiveness of antihypertensive therapy despite the more frequent use of polytherapy. One method for improving therapy effectiveness is by decreasing non-compliance with the use of fixed-dose combinations (FDC). The aim of this study was to assess the effectiveness, tolerance, and satisfaction with ramipril/amlodipine FDC antihypertensive therapy in relation to nutritional status.
  
  
  METHODS
  The survey enrolled 24,240 hypertensive patients recently switched to ramipril/amlodipine FDC (EGIRAMLON) at the same doses as previously prescribed separate pills.
  
  
  RESULTS
  The effectiveness of antihypertensive therapy increased during follow-up from 32.9% to 76.5%. Overweight and obesity were associated with the increased risk of not attaining the recommended BP values [adjusted for age OR=0.74 (95% CI 0.67-0.83) and 0.70 (0.61-0.81) for overweight; 0.54 (0.47-0.60) and 0.49 (0.42-0.57) for obese, at the first and the second examination, respectively]. "Very good" or "good" the FDP tolerance was reported by 98.8%, 97.6% and 96.4%, respectively. Adverse events (AE) were reported in 0.35% of patients regardless of nutritional status. High levels of satisfaction with the FDC were reported by 57.0% of patients with normal weight, 54.5% of overweight, and 50.6% with obesity. Effectiveness and convenience were the most important for patients.
  
  
  CONCLUSIONS
  The effectiveness of therapy with ramipril/amlodipine FDC in the study population was high, but slightly lower in overweigh and obese. This FDC was well tolerated and a significant number of patients satisfied with the therapy regardless of nutritional status. Although the perceived tolerance and satisfaction with treatment were lower in obese and overweight than in normal weight patients; the incidence of AE and perceived benefit from the use of a single-pill, compared to multiple tablets, were comparable irrespective of nutritional status.
authors.affiliation: Health Promotion and Obesity Management Unit, Department of Pathophysiology Medical University of Silesia, Katowice, Poland.
authors.forename: Magdalena
authors.initials: M
authors.lastname: Olszanecka-Glinianowicz
authors.affiliation: Pathophysiology Unit, Department of Pathophysiology Medical University of Silesia, Katowice, Poland.
authors.forename: Mike
authors.initials: M
authors.lastname: Smertka
authors.affiliation: Pharmacovigilance Unit, Europharma M. Rachtan Sp. z o.o., Katowice, Poland.
authors.forename: Agnieszka
authors.initials: A
authors.lastname: Almgren-Rachtan
authors.affiliation: Pathophysiology Unit, Department of Pathophysiology Medical University of Silesia, Katowice, Poland. Electronic address: chj@poczta.fm.
authors.forename: Jerzy
authors.initials: J
authors.lastname: Chudek
mesh_terms: D017311:Amlodipine / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D000959:Antihypertensive Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D001794:Blood Pressure / Q000187:drug effects; D004338:Drug Combinations; D006801:Humans; D006973:Hypertension / Q000188:drug therapy*; D055118:Medication Adherence; D009752:Nutritional Status; D009765:Obesity / Q000150:complications; D050177:Overweight / Q000150:complications; D017060:Patient Satisfaction; D017257:Ramipril / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*
chemical_list: D000959:Antihypertensive Agents; D004338:Drug Combinations; D017311:Amlodipine; D017257:Ramipril
keywords: Hypertension therapy; Nutritional status; Ramipril/amlodipine single-pill