Introduction: Fixed-dose combinations (FDCs) of antihypertensive agents improve therapeutic efficacy, according to current guidelines and large clinical studies.
Aim: 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.
Keywords: ACE inhibitor; Arterial hypertension; Blood pressure variability; Calcium channel blocker; Fixed-dose combination; Perindopril/amlodipine.