ACUTE MYOCARDIAL INFARCTION AND STROKE PREVENTION WITH AMLODIPINE/ ATORVASTATIN SINGLE-PILL THERAPY FOR PATIENTS WITH HYPERTENSION AND DYSLIPIDEMIA

Abstract

Objective: To evaluate the effect of suppressing the onset of Acute Myocardial Infarction (AMI) and Stroke by using combination tablet of Amlodipine Besilate/ Atorvastatin Calcium Hydrate (Caduet Combination Tablets) or combined use of Amlodipine Besilate and Atorvastatin Calcium Hydrate against patients with Hypertension and Dyslipidemia. Design and method: We build a Markov Model of considering the long-term treatment by using combination tablet of Amlodipine 5 mg/ Atorvastatin 10 mg or combined use of Amlodipine 5 mg and Atorvastatin 10 mg. The target patients were 60 years old with Hypertension (Systolic Blood Pressure 152mmHg) and Dyslipidemia (Total Cholesterol 288 mg/dL). The analyzed cycle was set for one year and we performed the simulation for the lifetime treatment. The medication adherence for the well treated group was 82.4% in the Combination Tablet treatment group and 61.0% in the combined treatment group. Medication adherence for the poor treated group was based on hypothesis as each clinical efficacy index was the same as before treatment. Results: The incidence of AMI and stroke during the lifetime in combination tablet treatment group was estimated to be 21.8% in male and 24.1% in female for patients without diabetes or smoking. For patients without diabetes but smoking, it was 35.8% and 40.6%. For patients with diabetes but no smoking, it was 31.1% and 48.5%. For patients with both diabetes and smoking, it was 47.4% and 68.5%. On the other hand, the incidence of AMI and stroke during the lifetime in combined treatment group was 24.7% in male and 27.5% in female for patients without diabetes or smoking. For patients without diabetes but smoking, it was 39.4% and 44.9%. For patients with diabetes but no smoking, it was 34.5% and 53.1%. For patients with both diabetes and smoking, it was 51.0% and 72.0%. The incidence of AMI and stroke was lower in the combination tablet treatment group compared to the combined treatment group in both men and female. Conclusions: Treatment with combination tablet against patients with hypertension and dyslipidemia improves the medication adherence which resulted in suppressing the onset of AMI and stroke.