Abstract
Objective: Objectives. To evaluate the effectiveness of perindopril arginine/ amlodipine single-pill combination (SPC) in patients with grade 1–2 hypertension uncontrolled on previous therapy with ARB-containing free combinations. Design and method: AVANGARD was a multicenter, open-label, 3-month Russian observational study, in 658 patients with suboptimal efficacy (SBP/DBP 140–179/90–109 mm Hg) of previous antihypertensive therapy with two drugs in free combination (one of which was an ARB), who were switched to perindopril arginine/amlodipine SPC. Data were collected at four visits: V1 (inclusion visit and treatment initiation), V2 (2 weeks), V3 (1 month), V4 (3 months). Results: The SBP/DBP values gradually and significantly decreased with Perindopril/amlodipine SPC from 159.9 ± 8.5/ 92.1 ± 7.4 mmHg to 141.3 ± 11.0/83.7 ± 7.5 mmHg after 2 weeks, 131.7 ± 9.2/79.5 ± 6.0 mmHg after 1 month and finally 125.8 ± 7.1 /77.4 ± 5.5 mm Hg; all p < 0.001). The controlled BP was achieved in 36.2%, 73.4 and 93.5% of patients at V2, V3 and V4, respectively. The mean HR followed the same patern (V1: 73.9 ± 7.3 beats per minute (bpm); V4: 68.9 ± 5.0 bpm; p < 0.001). Daytime 24-hour BP variability decreased from V2 to V4, from 4.4 ± 2.9/3.0 ± 2.0 to 3.0 ± 2.2/2.2 ± 1.7 mm Hg (p < 0.001). Treatment acceptability was very high considering couple related adverse events (0,21%) in accordance with the well-known side effects of the drugs (oedema and cough) Conclusions: This study showed the antihypertensive effectiveness of perindopril/amlodipine SPC in hypertensive patients previously uncontrolled on two-drug free combinations containing an ARB.
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