Effectiveness of Fixed-Dose Perindopril/Amlodipine on Clinic, Ambulatory and Self-Monitored Blood Pressure and Blood Pressure Variability: An Open-Label, Non Comparative Study in the General Practice.
BACKGROUND
Fixed-dose combinations (FDCs) of antihypertensive agents improve therapeutic efficacy, according to current guidelines and large clinical studies.


OBJECTIVE
This Russian study examined the effect on blood pressure (BP) of substituting current ineffective antihypertensive treatment with FDC perindopril/amlodipine in patients with uncontrolled hypertension.


METHODS
BP was measured in the doctor's office at each visit, daily at home, and by ambulatory monitoring (ABPM) at inclusion and end-of-study.


RESULTS
Ninety patients (52.7 ± 12.2 years old; mean baseline BP 161.4/94.9 mmHg) at high or very high cardiovascular risk were included. FDC perindopril/amlodipine (5/5, 10/5 or 10/10 mg) exerted a rapid (2 weeks) and significant (p < 0.001) reduction in clinic BP, maintained after 3 months (-33.7/17.1 mmHg). ABPM and home monitoring showed that BP decrease remained significant throughout the study (p < 0.0001). BP variability was reduced, indicating the stable and homogeneous 24-h antihypertensive effect of FDC perindopril/amlodipine. Quality of life and adherence were also improved.


CONCLUSIONS
The three main methods of BP assessment showed that substituting ineffective antihypertensive therapy with FDC perindopril/amlodipine resulted in a rapid and pronounced antihypertensive effect, with target BP levels achieved after 3 months in most patients. This beneficial effect was observed also on various parameters related to BP variability, which may reflect additional cardioprotective properties.
Federal State Institution "Russian Cardiology Scientific and Industrial Complex", 3rd Cherepkovskaya St. 15A, Moscow, 121552, Russia. anart_07@mail.ru.
Yuri A
YA
Karpov
National Research Center for Preventive Medicine, Moscow, Russia.
Vladimir M
VM
Gorbunov
National Research Center for Preventive Medicine, Moscow, Russia.
Alexander D
AD
Deev
D000328:Adult; D000368:Aged; D017311:Amlodipine / Q000009:adverse effects / Q000627:therapeutic use*; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000009:adverse effects / Q000627:therapeutic use*; D000959:Antihypertensive Agents / Q000009:adverse effects / Q000627:therapeutic use*; D001794:Blood Pressure / Q000187:drug effects*; D018660:Blood Pressure Monitoring, Ambulatory; D002121:Calcium Channel Blockers / Q000009:adverse effects / Q000627:therapeutic use*; D004338:Drug Combinations; D005260:Female; D058006:General Practice; D006801:Humans; D006973:Hypertension / Q000175:diagnosis / Q000188:drug therapy* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D009819:Office Visits; D020913:Perindopril / Q000009:adverse effects / Q000627:therapeutic use*; D011237:Predictive Value of Tests; D015203:Reproducibility of Results; D012426:Russia; D013997:Time Factors; D016896:Treatment Outcome
D000806:Angiotensin-Converting Enzyme Inhibitors; D000959:Antihypertensive Agents; D002121:Calcium Channel Blockers; D004338:Drug Combinations; C542336:amlodipine, perindopril drug combination; D017311:Amlodipine; D020913:Perindopril
ACE inhibitor; Arterial hypertension; Blood pressure variability; Calcium channel blocker; Fixed-dose combination; Perindopril/amlodipine