Combination Of Perindopril Research Articles

Research in brief

In the first of a pair of randomised, double-blind, placebo-controlled trials published in The Lancet, investigators of the TESLA Part B study assessed the efficacy of the PCSK9 antibody, evolocumab, for homozygous familial hypercholesterolaemia. Patients received monthly evolocumab (n=33) or placebo (n=16) for 12 weeks. The percentage change in ultracentrifugation LDL cholesterol from baseline to week 12 was −23·1% (95% CI −30·7 to −15·4) in the intervention group compared with 7·9% (−2·7 to 18·5) in the placebo group (treatment difference −30·9%, −43·9 to −18·0; adjusted p<0·0001). In the second study, the RUTHERFORD-2 trialists allocated patients with heterozygous familial hypercholesterolaemia to evolocumab (n=110) or placebo (n=54) once every 2 weeks, or monthly evolocumab (n=110) or placebo (n=55), for 12 weeks. Both doses of the study drug led to reductions in LDL cholesterol from baseline to week 12 compared with placebo (treatment difference for once every 2 weeks dose −59·2% [95% CI −65·1 to −53·4] and for the monthly dose −61·3% [–69·0 to −53·6]; p<0·0001 for both). Treatment was generally well tolerated. The CALORIES trial investigators have attempted to resolve the uncertainty regarding the delivery route for early nutritional support in critical care. Their pragmatic, open, multicentre, randomised trial included patients with an unplanned admission to ICU who required early nutritional support. Parenteral or enteral nutrition was administered for up to 5 days. 30 day mortality was 33% (393/1188) in patients allocated to parenteral nutrition and 34% (409/1195) in patients allocated to enteral nutrition; the difference between the groups was not statistically significant (absolute difference between groups 1·15, 95% CI −2·65 to 4·94). Incidence of hypoglycaemia and vomiting was lower in the parenteral group than in the enteral group. A phase 2 randomised dose-ranging trial of mirogabalin has yielded some promising results for people with diabetes and painful peripheral neuropathy. Investigators allocated 452 patients with type 1 or type 2 diabetes and painful peripheral neuropathy to placebo, five different doses of mirogabalin, or pregabalin (active comparator) for 5 weeks. Higher mirogabalin doses (15 mg/day, 20 mg/day, and 30 mg/day) were associated with significantly greater reductions in mean daily pain score from baseline to week 5 compared with placebo (least squares mean difference −0·94, −0·88, and −1·01, respectively; p<0·05). The most common adverse events associated with mirogabalin treatment were dizziness and somnolence. The ADVANCE-ON collaborators report the post-trial observational follow-up of 8494 patients with type 2 diabetes who had participated in the ADVANCE factorial trial. In the ADVANCE trial, although the combination of perindopril and indapamide for blood pressure lowering over 4·5 years was associated with a reduction in mortality, intensive glycaemic control over 5 years was not. In ADVANCE-ON, after 5·9 years post-trial follow-up, reductions in cardiovascular mortality (hazard ratio 0·88, 95% CI 0·77 to 0·99) and all-cause mortality (0·91, 0·84 to 0·99) persisted for the active blood pressure lowering treatment group. There were no differences in cardiovascular mortality or all-cause mortality between the intensive glycaemic control or standard care cohorts after 5·4 years of post-trial follow-up. Liraglutide treatment could have effects beyond glycaemic control alone, suggest the investigators of the LIBRA placebo-controlled trial. Researchers randomly assigned patients with type 2 diabetes to 48 weeks of daily placebo injection (n=25) or subcutaneous liraglutide (n=26). In advance of receiving treatment, all patients had 4 weeks of short-term intensive insulin treatment to improve glucotoxicity caused by diabetes. At 48 weeks, patients in the liraglutide cohort had better pancreatic β-cell function than those in the placebo group, as assessed by the Insulin Secretion-Sensitivity Index-2 (mean [SE] baseline adjusted values: 339·8 [27·8] and 229·3 [28·4], respectively; p=0·008). However, the beneficial effect on β cells was not maintained following termination of liraglutide treatment. Results from a single-centre randomised controlled trial cast the spotlight on the role of vitamin D in intensive care. Investigators for the VITdAL-ICU trial allocated critically ill patients with vitamin D deficiency to receive a loading dose of vitamin D3 (540 000 IU) or placebo, and then five, monthly, maintenance doses. The primary outcome did not differ between groups assigned to vitamin D3 (n=237) or placebo (n=238), with patients receiving vitamin D3 staying in hospital for a median of 20·1 days (IQR 11·1–33·3), and placebo patients for 19·3 days (11·1–34·9; p=0·98). Length of ICU stay, in-hospital death, and death at 6 months did not significantly differ between the two groups.

Follow-up of Blood-Pressure Lowering and Glucose Control in Type 2 Diabetes

BackgroundIn the Action in Diabetes and Vascular Disease: Preterax and Diamicron Modified Release Controlled Evaluation (ADVANCE) factorial trial, the combination of perindopril and indapamide reduced mortality among patients with type 2 diabetes, but intensive glucose control, targeting a glycated hemoglobin level of less than 6.5%, did not. We now report results of the 6-year post-trial follow-up.MethodsWe invited surviving participants, who had previously been assigned to perindopril–indapamide or placebo and to intensive or standard glucose control (with the glucose-control comparison extending for an additional 6 months), to participate in a post-trial follow-up evaluation. The primary end points were death from any cause and major macrovascular events.ResultsThe baseline characteristics were similar among the 11,140 patients who originally underwent randomization and the 8494 patients who participated in the post-trial follow-up for a median of 5.9 years (blood-pressure–lowering comparison) or 5.4 years (glucose-control comparison). Between-group differences in blood pressure and glycated hemoglobin levels during the trial were no longer evident by the first post-trial visit. The reductions in the risk of death from any cause and of death from cardiovascular causes that had been observed in the group receiving active blood-pressure–lowering treatment during the trial were attenuated but significant at the end of the post-trial follow-up; the hazard ratios were 0.91 (95% confidence interval [CI], 0.84 to 0.99; P=0.03) and 0.88 (95% CI, 0.77 to 0.99; P=0.04), respectively. No differences were observed during follow-up in the risk of death from any cause or major macrovascular events between the intensive-glucose-control group and the standard-glucose-control group; the hazard ratios were 1.00 (95% CI, 0.92 to 1.08) and 1.00 (95% CI, 0.92 to 1.08), respectively.ConclusionsThe benefits with respect to mortality that had been observed among patients originally assigned to blood-pressure–lowering therapy were attenuated but still evident at the end of follow-up. There was no evidence that intensive glucose control during the trial led to long-term benefits with respect to mortality or macrovascular events. (Funded by the National Health and Medical Research Council of Australia and others; ADVANCE-ON ClinicalTrials.gov number, NCT00949286.)

The impact of fixed combination of amlodipine and perindopril (drug Prestance)on the mechanisms of heat adaptation in patients with arterial hypertension

Relevance. The impact of the drugs on adaptation to the heat wave of abnormal temperature has been one of the most important practical medicine questions, concerning heat waves, recent years. One of the points at issue is safety administration of calcium channel antagonists and ACE inhibitors during abnormal heat.Aim of the study is to assess the efficacy and safety of the fixed combination of perindopril arginine (drug Prestance, Servier Industries, Ltd.)/amlodipine in patients with arterial hypertension (AH) during the summer heat and the summer heat influence on the mechanisms of heat adaptation to abnormally high temperature.Material and methods: The study enrolled 165 patients with stages 1-2 AH: 69 patients with average risk and 91 patients with high/very high risk of cardiovascular complications. There were 69 men and 96 women in the study, living in Moscow city, in the Moscow and in the Ivanovo Regions. All patients were measuring office BP, undergoing biochemical analysis of blood, running questionnaire survey: visual analogue scale (VAS), questionnaire for the patients who were exposed to heat, the level of products reacting with the 2-thiobarbituric acid (malonyldialdehyde, MDA) and activity of superoxide dismutase (SOD) using standard test-kits and the pulse ware velocity (PWV) was measured in 30 patients. The first visit was in the first half of June 2013, the second visit - during the heat (July 2013) and the third one in September 2013.Results: In the course of the study SBP (systolic BP) and DBP (diastolic BP) were reduced (р

Perindopril is angiotensin-converting enzyme inhibitor in treatment patients with arterial hypertension

According to the 2013 ESH guidelines, it is possible to use any group of known antihypertensive drugs in the treatment of arterial hypertension. But we often have been using different combinations of drugs. In this situation, using drugs combination in fixed dosage increases patients acceptance of therapy and makes treatment easier. According to the results of the numerous studies, perindopril statistically significant reduces total and cardiovascular mortality and the incidence of myocardial infarction. The combination of perindopril and calcium antagonist makes the drug more effective.

Triple combination therapy in hypertension: the antihypertensive efficacy of treatment with perindopril, amlodipine, and indapamide SR.

The blood pressure (BP) of most patients on antihypertensive monotherapy or bitherapy remains uncontrolled. Our study evaluated the efficacy of triple therapy with perindopril, amlodipine, and indapamide sustained release (SR) in patients with uncontrolled hypertension on previous antihypertensive therapy. This 4-month, multicenter, prospective, observational, open-label study included patients switched from previous antihypertensive therapy to triple therapy with perindopril, amlodipine, and indapamide SR. The main outcome was change in office BP from baseline to 4 months, as well as changes in 24-h ambulatory BP monitoring (ABPM) parameters in a subgroup of patients. Age was 62.8 ± 11.3 years in 6,088 patients (55 % were male). Office BP at baseline was 158.1 ± 13.0/92.6 ± 8.8 mmHg. By 4 months, office BP decreased by 26.7 ± 13.3/12.9 ± 9.4 mmHg (p < 0.001). ABPM was performed in 62 patients. In these patients, 24-h systolic BP decreased (from 138.7 ± 12.5 to 125.5 ± 12.8 mmHg), as did 24-h diastolic BP (from 77.5 ± 11.4 to 70.4 ± 8.7 mmHg) (both p < 0.0001). Heart rate remained unchanged. In patients previously on renin-angiotensin-aldosterone system (RAAS) inhibitor/amlodipine, 24-h ambulatory systolic and diastolic BP decreased from 136.9 ± 12.8 to 125.4 ± 13.3 mmHg (p = 0.0003) and from 76.3 ± 12.6 to 70.2 ± 9.5 mmHg (p = 0.0005). In those previously on RAAS inhibitor/hydrochlorothiazide, 24-h ambulatory systolic and diastolic BP decreased from 137.8 ± 12.7 to 122.7 ± 15.4 mmHg (p = 0.0039) and from 73.6 ± 9.4 to 65.7 ± 7.3 mmHg (p = 0.002). Most (74 and 80 %, respectively) patients reached target ABPM values (<130/80 mmHg). A triple combination of perindopril, amlodipine, and indapamide SR controlled BP effectively in hypertensive patients uncontrolled by previous antihypertensive monotherapy or bitherapy, including RAAS inhibitor/amlodipine or RAAS inhibitor/hydrochlorothiazide combinations.

Antihypertensive Treatment and Kidney Function in Routine Practice in Patients with Type 2 Diabetes Mellitus: The Results of the Prospective "The Scythian" Trial in Ukraine

Background : Hypertension, albuminuria and decreased GFR are regarded as independent risk factors that reflect progression of the diabetic kidney disease (DKD). We carried out second phase of prospective study which aim was to learn the possibility of implementation of intensive antihypertensive therapy into the routine clinical practice and assessment of such treatment influence on kidney function in patients with type 2 diabetes mellitus (T2DM). Methods : In the study 637 patients were included with DKD and arterial hypertension with BP level more than 130/80 mmHg and less than 1800 mmHg, having chronic kidneys disease (CKD) 1-4. As a basis for intensive antihypertensive treatment fixed combination of perindopril 5 mg and indapamide 1.25 mg were prescribed. If needed, after 4 weeks the dosage was increased up to perindopril 10 mg/ indapamide 2.5 mg to achieve targeted BP less that 130/80 mmHg. If targeted BP had not been achieved other antihypertensive preparations were added. Results : After 4 weeks of treatment average levels of systolic and diastolic BP were 141.3±0.5 and 86.3±0.3, after 8 weeks of therapy – 131.6±0.4 and 81.3±0.3 mmHg, and after 12 weeks of treatment –127.2±0.3 and 78.7±0.2 mmHg respectively. Target BP was achieved in 489 patients (73.3%) during 12 weeks of treatment. Statistically significant increase of GFR as a result of 12 weeks of antihypertensive therapy with fixed perindopril/indapamide combination was found to be between 84.3±1.1 and 94.7±1.1 ml/min./1,73m2, р&lt;0.01. Conclusion : Antihypertensive therapy with fixed combination of perindopril 5-10 mg/indapamide 1.25-2.5 mg introduced into routine clinical practice of T2DM patients’ treatment, is effective for BP reduction, achievement of its targeted values and resulted in statistically significant trend to kidney function improvement.

Functional impairment and Internet use among older adults: implications for meaningful use of patient portals.

Functional impairment and Internet use among older adults: implications for meaningful use of patient portals.

Tacrolimus-induced hypertension and nephrotoxicity in Fawn-Hooded rats are attenuated by dual inhibition of renin–angiotensin system

Chronic immunosuppressive therapy is often complicated by the development of both arterial hypertension and renal dysfunction. The principal aim of this study was to assess the effects of dual inhibition of renin-angiotensin system (RAS) and other antihypertensive treatment on blood pressure and renal function in normotensive and hypertensive Fawn-Hooded (FH) strains during chronic calcineurin inhibitor (CNI) administration. Combinations of perindopril (5 mg kg(-1) per day) and losartan (50 mg kg(-1) per day) or amlodipine (6 mg kg(-1) per day) and metoprolol (80 mg kg(-1) per day) were administered to normotensive (FHL) and hypertensive (FHH) rats, fed with diet containing tacrolimus (Tac; 12 mg kg(-1) per day). Tac-induced arterial hypertension in both animal strains (FHL: 151±4; FHH: 198±6 mm Hg) was prevented by dual RAS inhibition (FHL: 132±3 mm Hg, P<0.05; FHH: 153±3 mm Hg, P<0.05) as well as by a combination of amlodipine and metoprolol (FHL: 136±3 mm Hg, P<0.05; FHH: 166±4 mm Hg, P<0.05). However, significant nephroprotection was observed only in animals on dual RAS inhibition where albuminuria was reduced in both FHL (51.1±3.9 vs. 68.3±4.5 μg per day; P<0.05) and FHH rats (13.1±0.3 vs. 18.8±0.7 mg per day; P<0.05). We also found Tac-induced enhancement in renal angiotensin II activity that was significantly reduced by dual RAS inhibition in both FHL (63.5±3.2 vs. 23.1±3.0 fmol g(-1)) and FHH (79.8±8.5 vs. 32.2±5.8 fmol g(-1)). In addition, histological analysis revealed that RAS inhibition noticeably diminished glomerulosclerosis and tubulo-interstitial injury. This study indicates that dual blockade of RAS significantly attenuates Tac-induced arterial hypertension and nephrotoxicity in FH rats and further supports the notion that RAS inhibitors display efficient renoprotective properties during CNI treatment.

Efficacy and Tolerability of Fixed-Dose Combination of Perindopril/Indapamide in Type 2 Diabetes Mellitus: PICASSO Trial

BackgroundHypertension and type 2 diabetes mellitus (T2DM) synergistically deteriorate the vascular environment, making blood pressure reduction challenging, and substantially increasing cardiovascular risk.MethodsIn the real-life, open-label, observational, PICASSO study, 9,257 hypertensive patients unsuccessfully treated with antihypertensives were switched to fixed-dose combination of perindopril 10 mg/indapamide 2.5 mg. In this subgroup analysis, we analyzed changes in blood pressure and laboratory parameters of 2,762 hypertensive patients with T2DM or pre-diabetes.ResultsAfter 3 months of treatment, significant decreases in office blood pressure were noted in the whole cohort (−27.0 ± 14.8/−12.7 ± 9.8 mmHg; p < 0.001). Significant decreases were also recorded in patients with grade 1 hypertension (19.2 ± 10.0/−9.4 ± 7.9 mmHg), grade 2 (29.2 ± 10.9/−13.3 ± 8.7 mmHg) and grade 3 (−45.1 ± 15.4/−21.5 ± 11.2 mmHg). Significant decreases in ambulatory blood pressure were also noted (n = 93). In patients previously treated with angiotensin-converting enzyme inhibitor ± hydrochlorothiazide or angiotensin receptor blocker ± hydrochlorothiazide, mean 24-h blood pressure decreased by 23.4 ± 13.9/11.5 ± 9.7 and 22.3 ± 8.7/10.4 ± 13.2 mmHg, respectively (p < 0.001). Treatment was well tolerated and the switch to treatment with perindopril/indapamide was associated with improvements in laboratory parameters.ConclusionsData from this diabetes subgroup analysis suggest that fixed combination of perindopril 10 mg/indapamide 2.5 mg should be routinely considered for the treatment of hypertension in diabetic patients who are unsuccessfully managed with other antihypertensive medications.Electronic supplementary materialThe online version of this article (doi:10.1007/s12325-014-0107-y) contains supplementary material, which is available to authorized users.

Effects of Combination of Perindopril, Indapamide, and Calcium Channel Blockers in Patients With Type 2 Diabetes Mellitus

The objective of the present analysis was to determine the effects of a fixed combination of perindopril and indapamide in combination with calcium channel blockers (CCBs) in patients with type 2 diabetes mellitus. The Action in Diabetes and Vascular Disease: Preterax and Diamicron Controlled Evaluation (ADVANCE) trial was a factorial randomized controlled trial. A total of 11 140 patients with type 2 diabetes mellitus were randomly assigned to fixed combination of perindopril–indapamide (4/1.25 mg) or placebo. Effects of randomized treatment on mortality and major cardiovascular outcomes were examined in subgroups defined by baseline use of CCBs. Patients on CCB at baseline (n=3427) constituted a higher risk group compared with those not on CCB (n=7713), with more extensive use of antihypertensive and other protective therapies. Active treatment reduced the relative risk of death by 28% (95% confidence interval, 10%–43%) among patients with CCB at baseline compared with 5% (−12% to 20%) among those without CCB ( P homogeneity=0.02) and 14% (2%–25%) for the whole population. Similarly, the relative risk reduction for major cardiovascular events was 12% (−8% to 28%) versus 6% (−10% to 19%) for those with and without CCB at baseline although the difference was not statistically significant ( P homogeneity=0.38). There was no detectable increase in adverse effects in those receiving CCB. The combination of perindopril and indapamide with CCBs seems to provide further protection against mortality in patients with type 2 diabetes mellitus.

CHRONIC KIDNEY DISEASE AND CEREBROCARDIOVASCULAR COMPLICATIONS IN ARTERIAL HYPERTENSION: RESULTS OF PERINDOPRIL А USAGE WITH INDAPAMID

Aim. To evaluate the development of cardio- and cerebrovascular complications in arterial hypertension depending on presence or absence of kidney injury, to evaluate organoprotective activity of perindopril with indapamide (the medications Noliprel A and Noliprel A Forte). Material and methods. The three-year prospective investigation has been performed on 52 outpatients with AH. The diagnosis of CKD was set according to KDOQI 2002 guidelines. All patients received antihypertensive therapy with Noliprel 2,5 + 0,625 mg (Noliprel A) — (10) or 5 + 1,25 mg (Noliprel A Forte) — (42). Control group — 25 patients on antihypertensive treatmient without Noliprel. Primary endpoint was the development of CKD or worsening of already persisting CKD to the next stage. Secondary endpoints: cardio- and cerebrovascular accident (myocardial infarction, ischemic stroke, transitory ischemic attack). Results. In the group of therapy with combination of perindopril A with indapamide primary endpoint was reached by 12 (23%) patients, in the group without this combination in 12 (48%) patients, p=0,05. Regression of severity of CKD was marked in 5 (15,5%) patients in the main group and in no one in comparison group. In the main group with CKD the cardiocerebral events occured in 11 (33,3%) patients, in the group without kidney injury in 1 (5,25%) patient had cardiocerebral event, p<0,05. Between the main and the comparison groups there are also significant differences by the prevalence of myocardial infarction and ischemic stroke: 12 (23%) vs. 14 (56%), p=0,009. In the group of patients not taken combination of perindopril A with indapamide, cardiovascular accidents occur almost 10 times more often than in the main group without CKD, and almost 2 times more often than in CKD group with drug combination. Conclusion. Prospective observation has shown higher prevalence of ischemic stroke and transient ischemic attack, and cardiovascular accidents in the group of patients with chronic kidney disease comparing to the group without kidney injury. Dynamic observation of the AH patients, use of perindopril+indapamide combination allows to reach antihypertensive and organoprotective aim.

Ингибитор ангиотензинпревращающего фермента периндоприл в лечении пациентов с артериальной гипертензией

According to the 2013 ESH guidelines, it is possible to use any group of known antihypertensive drugs in the treatment of arterial hypertension. But we often have been using different combinations of drugs. In this situation, using drugs combination in fixed dosage increases patients acceptance of therapy and makes treatment easier. According to the results of the numerous studies, perindopril statistically significant reduces total and cardiovascular mortality and the incidence of myocardial infarction. The combination of perindopril and calcium antagonist makes the drug more effective.

The comparative analysis of therapy by «typical practice» and the fixed combination perindopril and indapamide an arterial hypertension with kidney insufficiency

Results of the conducted prospektivny clinical research devoted to a comparative assessment of hypotensive and nefroprotektivny efficiency of the fixed combination perindopril and indapamid in comparison with by «typical practice» treatments of an arterial hypertension with kidney insufficiency on the frequency of achievement and maintenance of level of target arterial pressure, dynamics of a system glomerular filtration of a formula to the Cockcroft-Gault.

Perindopril treatment promote left ventricle remodeling in patients with heart failure screened positive for autoantibodies against angiotensin II type 1 receptor

BackgroundAutoantibodies specific to the angiotensin II type I receptor (anti-AT1-AR) have been implicated in the pathology of congestive heart failure (CHF). Anti-AT1-AR may be associated with left ventricular function in CHF patients treated with perindopril.MethodsSynthetic angiotensin II type 1 receptor (AT1-R) peptides served as the target antigen. ELISA was used to screen the sera of 156 CHF patients, which were divided into positive and negative groups based on their anti-AT1-AR reactivity. Echocardiography and a 6-minute walk test were performed at baseline and after one year of perindopril therapy. The end-point events were compared over a 5-year follow-up.ResultsFinal analysis covered 138 patients, including 82 positive and 56 negative. The frequency and geometric mean titre of anti-AT1-AR were significantly lower in the positive group after one year of treatment (all P < 0.01, from 100% to 73.2% and from 1:125.3 ± 1.0 to 1:69.2 ± 1.1). Of these, 22 patients showed no antibodies. Both groups showed improvement in left ventricular end-diastole, end-systolic dimensions, ejection fraction, and a 6-minute walk test by perindopril in combination with standard treatment regime for one year (all P < 0.01). However, the 82 patients positive for anti-AT1-AR showed more pronounced improvement than the 56 negative patients (all P < 0.05). However, after 5 years of follow-up, the rate of all causes and cardiovascular mortality attributable to any cause and the re-hospitalisation rate showed no significant differences between the two groups (all P > 0.05).ConclusionsPerindopril treatment significantly decreased the frequency and geometric mean titre in patients positive for anti-AT1-AR, even to complete ablation. These patients showed greater improvement in left ventricular remodeling and heart function than negative that in patients after one year of perindopril treatment in combination with standard treatment, but no significant differences in endpoint events were observed in the following 5 years. Anti-AT1-AR might be a useful biomarker of over-activation of the renin-angiotensin-aldosterone system for clinical medication.

CLINICAL AND ECONOMIC ANALYSIS: FIXED COMBINATION PERINDOPRIL ARGININE/INDAPAMIDE RETARD VERSUS «TRADITIONAL TREATMENT» IN HYPERTENSIVE PATIENTS WITH RENAL INSUFFICIENCY

Objective. To perform a clinical and economic analysis in order to assess the beneits of antihypertensive and renal protective effects of the ixed combination perindopril arginine and indapamide in versus «traditional therapy» in hypertensive patients with renal insuficiency. Design and methods. We evaluated an indicator «costs-eficiency» by the cost of increase of glomerular iltration by 1 ml/hour (by Cockcroft-Gault formula, in each of group and decrease by 1 mg/l of proteinuria in both groups. Results and conclusions. Fixed combination of perindopril arginine/indapamide is economically beneicial according to the index «costs-eficiency» compared to traditional therapy.

A FIXED COMBINATION OF PERINDOPRIL AND AMLODIPINE IN HYPERTENSIVE PATIENTS WITH ACUTE CORONARY SYNDROME: A CLINICAL EXPERIENCE

Objective. To assess the eficacy and tolerability of a ixed combination of perindopril and amlodipine in patients with acute coronary syndrome and hypertension III stage 2 and 3 degree.Results and conclusion. The drug (perindopril plus amlodipine 10/5 mg) was shown to provide a high 24-hour antihypertensive eficacy, leading to a signiicant decrease in blood pressure and heart rate. The drug was well tolerated, and the drug withdrawal was not required.

Fixed dose combination of perindopril and indapamide in the treatment of arterial hypertension

Fixed dose combination of perindopril and indapamide in the treatment of arterial hypertension

Reducing cardiovascular risk in diabetes: insights from the ADVANCE study

BACKGROUND Blood pressure is an important determinant of the risks of macrovascular and microvascular complications of type 2 diabetes. That’s why guidelines recommend intensive lowering of blood pressure in those patients. The ADVANCE (Action in Diabetes and Vascular disease: preterAx and diamicroN-MR Controlled Evaluation) study has been recently introduced. It assessed the effects of such an approach on vascular disease using a fixed combination of the ACE-inhibitor perindopril, and the diuretic indapamide, in a population of patients with type 2 diabetes and a broad range of blood pressure values. METHODS After a 6-week active run-in period, 11,140 patients with type 2 diabetes were randomised to treatment with a fixed combination of perindopril and indapamide or matching placebo, in addition to current therapy. Primary end-points: major macrovascular and microvascular events, defined as death from cardiovascular disease, non-fatal stroke or non-fatal myocardial infarction, and new or worsening renal or diabetic eye disease. The macrovascular and microvascular composites were analysed jointly and separately. RESULTS To the end of the follow-up a meaningful reduction of the deaths has been obtained, both for cardiovascular causes and for macro and microvascular events, examined in together (in the total) (separately significance has not turned out). The best result has been obtained in the reduction of the renal events. DISCUSSION AND CONCLUSIONS The authors conclude that routine administration of a fixed combination of perindopril and indapamide to patients with type 2 diabetes and with a good controlled blood pressure, was well tolerated and reduced the risks of major vascular events, including death, but it remains the doubt if these results have been obtained because of the better pressure control or are specific of this preconstructed association.

Effect of a fixed combination of Perindopril and Amlodipine on blood pressure control in 6256 patients with not-at-goal hypertension: the AVANT’AGE study

In clinical practice, general practitioners are likely to face hypertensives with uncontrolled blood pressure (BP), whose antihypertensive treatment need to be modified. In the present study, 710 general practitioners have each included the first 10 patients with not-at-goal hypertension, for whom they decided to modify their antihypertensive treatment with addition of a fixed combination of Perindopril and Amlodipine at either of its four dosages: 5/5, 5/10, 10/5, or 10/10 mg. In total, 6256 patients were included, with BP measured both at baseline and after 3 months. At the end of follow-up, a mean reduction of 20.3 ± 12.4 mm Hg in systolic BP and 11.3 ± 9.6 mm Hg in diastolic BP were observed, and 62.3% achieved successful BP control. Body mass index and waist circumference were significant determinants of both systolic and diastolic BP reductions (P ≤ .04). Moreover, in addition to baseline BP level, body mass index was the only significant determinant of BP control of systolic, diastolic BP, and of both (P ≤ .04). Addition of a fixed combination of Perindopril and Amlodipine to BP regimen was efficient, in terms of BP control, for 62.3% of those patients with not-at-goal hypertension. Furthermore, baseline BP level and obesity were important influential factors of BP control.

Experience of using a fixed-dose combination of perindopril and amlodipine in the clinical practice settings: a real-world opportunity to increase antihypertensive therapy effectiveness

The paper presents the results of the studies on effectiveness and safety of a fixeddose combination of perindopril A and amlodipine (Prestans) in the real-world clinical practice settings in Russia and other countries. The focus is on the evidence of fast and strong antihypertensive action of this medication, its excellent tolerability, and increased therapy compliance. The evidence presented justifies a wider use of this fixed-dose combination of perindopril A and amlodipine in order to improve blood pressure control in hypertensive patients.