title: Rationale for a single-pill combination of perindopril arginine and amlodipine besylate.
abstract: A systematic review identified 86 outcome-based clinical trials involving perindopril, amlodipine, or other antihypertensive drugs. In fixed-effects meta-analyses of 11 clinical trials (90,208 subjects), amlodipine was associated with a significant 24% increase in heart failure, but a significant decrease in death, cardiovascular death, stroke, coronary heart disease, and first major cardiovascular adverse event. In five clinical trials (52,565 subjects), perindopril was associated with a significant reduction in all six cardiovascular endpoints. Network and Bayesian meta-analyses suggested that (with the exception of amlodipine and heart failure), each agent was at least as effective as an initial diuretic to prevent these events. Short-term trials have demonstrated that the combination of perindopril and amlodipine is safe and effective, with statistically greater lowering of blood pressure than either agent alone and a potential synergistic effect on pedal edema. The single-pill combination of perindopril and amlodipine may be a useful addition to the antihypertensive armamentarium.
authors: Division of Pharmacology, Department of Biomedical Sciences, Pacific Northwest University of Health Sciences, Yakima, WA. Electronic address: wj.elliott@yahoo.com.
authors: William J
authors: WJ
authors: Elliott
mesh_terms: D017311:Amlodipine / Q000627:therapeutic use*; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000517:prevention & control; D002986:Clinical Trials as Topic; D004338:Drug Combinations; D006801:Humans; D020913:Perindopril / Q000627:therapeutic use*
chemical_list: D000959:Antihypertensive Agents; D004338:Drug Combinations; D017311:Amlodipine; D020913:Perindopril
keywords: Cardiovascular events; fixed–effects; heart failure; network and Bayesian meta–analyses; random–effects