Effectiveness and Tolerability of Bisoprolol/Perindopril Single-Pill Combination in Patients with Arterial Hypertension and a History of Myocardial Infarction: The PRIDE Observational Study.

Abstract

This study assessed the real-life effectiveness of a single-pill combination (SPC) of bisoprolol/perindopril for controlling blood pressure (BP) and symptoms of angina in patients with hypertension and a history of myocardial infarction (MI). Eligible patients with arterial hypertension and a history of MI were aged 18-79years and had initiated bisoprolol/perindopril SPC within 3months of study enrollment as part of routine Russian clinical practice. The primary endpoint was mean change in systolic and diastolic BP (SBP/DBP) at week12 compared with baseline (data collected retrospectively). Secondary endpoints were assessed at weeks4 and 12 and included mean change in resting heart rate (HR), proportion of patients reaching target level of resting HR, antianginal effectiveness of the SPC, and proportion of patients reaching target BP levels. A total of 504 patients were enrolled, of whom 481 comprised the full analysis set (mean age 61.4 ± 8.9years, 68% men). Mean baseline SBP/DBP and HR values were 148.9 ± 16.8/87.7 ± 11.0mmHg and 77.4 ± 10.5bpm, respectively. Mean durations of hypertension and CAD were 12.8 ± 8.4 and 6.1 ± 6.3years, respectively, and time since MI was 3.8 ± 5.3years. At week12, SBP/DBP had decreased by 24.9/12.2mmHg (P < 0.001 vs baseline). Target BP (< 140/90mmHg) was achieved by 69.8% and 95.9% of patients at weeks4 and 12, respectively, and target HR (55-60bpm) by 17.3% and 34.5% at weeks4 and 12 versus 3.1% at baseline (P < 0.001). Reductions in angina attacks, nitrate consumption, and improvements in HR were statistically significant. Treatment was well tolerated. Treatment of symptomatic patients with CAD, hypertension, and a history of MI with a bisoprolol/perindopril SPC was associated with significant decreases in SBP/DBP and a high proportion of patients achieving BP treatment goals. This was accompanied by improvements in angina symptoms and reductions in HR in a broad patient population representative of those seen in everyday clinical practice. ClinicalTrials.gov Identifier NCT04656847.