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Evaluation of the Safety and Efficacy of Dual Therapy Perindopril/Amlodipine in the Management of Hypertension. A Systematic Review and Meta-Analysis

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Abstract

Introduction

Hypertension represent the commonest cause of death in 2017. Hypertension is classified into two types which are primary or essential hypertension and secondary hypertension. The perindopril–amlodipine combination showed a significant effect in reduction of the elevated BP and the cardiovascular complications.

Aim

To evaluate the efficacy and safety of a fixed-dose single-pill combination of perindopril–amlodipine in hypertensive patients.

Methods

We searched PubMed, Medline, SCOPUS, and Web of Science for relevant clinical trials. Quality appraisal was evaluated according to GRADE and we assessed the risk of bias using Cochrane’s risk of bias tool. We included the following outcomes: systolic blood pressure, diastolic blood pressure, pulse pressure, mean blood pressure, heart rate, cough, dizziness, headache, and peripheral edema. We performed the analysis of homogeneous data under the fixed-effects model, while analysis of heterogeneous data was analyzed under the random-effects model. We conducted a meta-regression according to the dose.

Results

We included ten clinical trials. The pooled analysis showed that there was a significant reduction of the systolic blood pressure, diastolic blood pressure, pulse plessure, mean blood pressure, and heart rate after the the perindopril–amlodipine combination (MD = 18.96 [14.32, 23.60], P < 0.0001), (MD = 11.90 [8.45, 15.35], P < 0.0001), (MD = 8.44 [6.91, 9.97], P = 0.0001), (MD = 13.07 [5.86, 20.29], P = 0.0004), and (MD = 2.93 [0.89, 4.96], P = 0.005), respectively. The results of the meta-regression revealed that the efficacy is increased by increasing the dose (P < 0.001)

Conclusion

The use of the perindopril–amlodipine combination had a significant effect on the reduction of SBP, DBP, mean blood pressure, pulse pressure, and HR.

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Data Availability

Data will be available to any researcher who contact the corresponding author.

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Funding

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Authors and Affiliations

  1. Department of Internal Medicine, Al-Azhar University, Cairo, Egypt

    Sadek Mostafa, Hosam Shabana, Farag Khalil, Ismail Mohamed El Mancy, Hendawy Abdel-Moety Zedan, Ibrahim Ghounim Ramadan & Arafat Kassem

  2. College of Medicine, University of Kentucky, Lexington, KY, USA

    Ahmed Elmoursi

  3. Department of Internal Medicine, Al-Azhar University, Damietta, Egypt

    Saad El Deen Mohamed

  4. Fayoum University Hospital, Fayoum, Egypt

    Islam Shawky Kamel

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  1. Sadek Mostafa
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  2. Hosam Shabana
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Correspondence to Islam Shawky Kamel.

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Mostafa, S., Shabana, H., Khalil, F. et al. Evaluation of the Safety and Efficacy of Dual Therapy Perindopril/Amlodipine in the Management of Hypertension. A Systematic Review and Meta-Analysis. High Blood Press Cardiovasc Prev 29, 565–576 (2022). https://doi.org/10.1007/s40292-022-00544-3

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