PS-C22-11: EFFICACY OF TRI-COMBINATION ACEI PLUS AMLODIPINE AND INDAPAMIDE VERSUS ARB AMLODIPINE AND THIAZIDE IN DIABETES WITH HYPERTENSION PATIENTS

Abstract

Introduction: Global Burden of Disease (GBD) Study has estimated that Hypertension leads to 1.6 million deaths and 118 million disability-adjusted life years in INDIA1 40% of diagnosed Hypertension patients are treated1. The poor control rates among treated Hypertension patients are around 40% in Indian3. Plausible reasons for poor Hypertension control rates in INDIA. This is mainly because most treated patients only receive monotherapy despite guidelines recognizing that most patients require combination therapy 2 and 3. ISH 2020 guidelines support initiating with A+C SPC in Hypertension patients For patients uncontrolled on two drugs, recommended approaches are to increase doses as step 2 and add a third drug as step 3. 4 Every third Hypertension patient needs three or more drugs to reach the BP Perindopril + Amlodipine + Indapamide offers better blood pressure control. In studies such as the ADVANCE CCB study5. Active treatment with Perindopril + Indapamide + CCB reduced the relative risk of death by -28%. -The recent Mazza et al. study provides evidence for Cardiovascular risk reduction with Perindopril + Indapamide + Amlodipine combination. Left ventricular hypertrophy (LVH) regression was greater in the SPC group of Perindopril+ Indapamide+ Amlodipine vs. the FCT group (43.5% vs. 30.4%, P < 0.05).6 In our Indian study from 2019 to 2022, 110 patients with Diabetes with Moderate to severe Hypertension on Perindopril with Amlodipine and Indapamide were able to achieve a blood pressure target of < 130/80 mmHg with Minimum 6 months to a maximum of 2 years on this combination therapy, whereas Target of < 130/80 mmHg with ARB with Amlodipine and thiazide were achieved in 54% only, which was significant (Figure 1). Indian patients are well Tolerated with triple single Pill, and adherence to therapy was Good.