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Ramipril/amlodipine single pill — Effectiveness, tolerance and patient satisfaction with antihypertensive therapy in relation to nutritional status

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Abstract

Background

Overweight and obesity decrease the effectiveness of antihypertensive therapy despite the more frequent use of polytherapy. One method for improving therapy effectiveness is by decreasing non-compliance with the use of fixed-dose combinations (FDC).

The aim of this study was to assess the effectiveness, tolerance, and satisfaction with ramipril/amlodipine FDC antihypertensive therapy in relation to nutritional status.

Methods

The survey enrolled 24,240 hypertensive patients recently switched to ramipril/amlodipine FDC (EGIRAMLON) at the same doses as previously prescribed separate pills.

Results

The effectiveness of antihypertensive therapy increased during follow-up from 32.9% to 76.5%. Overweight and obesity were associated with the increased risk of not attaining the recommended BP values [adjusted for age OR = 0.74 (95% CI 0.67–0.83) and 0.70 (0.61–0.81) for overweight; 0.54 (0.47–0.60) and 0.49 (0.42–0.57) for obese, at the first and the second examination, respectively].

“Very good” or “good” the FDP tolerance was reported by 98.8%, 97.6% and 96.4%, respectively.

Adverse events (AE) were reported in 0.35% of patients regardless of nutritional status.

High levels of satisfaction with the FDC were reported by 57.0% of patients with normal weight, 54.5% of overweight, and 50.6% with obesity. Effectiveness and convenience were the most important for patients.

Conclusions

The effectiveness of therapy with ramipril/amlodipine FDC in the study population was high, but slightly lower in overweigh and obese. This FDC was well tolerated and a significant number of patients satisfied with the therapy regardless of nutritional status. Although the perceived tolerance and satisfaction with treatment were lower in obese and overweight than in normal weight patients; the incidence of AE and perceived benefit from the use of a single-pill, compared to multiple tablets, were comparable irrespective of nutritional status.

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Abbreviations

AE:

adverse event

BMI:

body mass index

BP:

blood pressure

CI:

confidence interval

FDC:

fixed-dose combinations

OR:

odds ratio

RH:

resistant hypertension

WHO:

World Health Organization

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Authors and Affiliations

  1. Health Promotion and Obesity Management Unit, Department of Pathophysiology Medical University of Silesia, Katowice, Poland

    Magdalena Olszanecka-Glinianowicz

  2. Pathophysiology Unit, Department of Pathophysiology Medical University of Silesia, Katowice, Poland

    Mike Smertka & Jerzy Chudek

  3. Pharmacovigilance Unit, Europharma M. Rachtan Sp. z o.o., Katowice, Poland

    Agnieszka Almgren-Rachtan

Authors
  1. Magdalena Olszanecka-Glinianowicz
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  2. Mike Smertka
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  3. Agnieszka Almgren-Rachtan
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  4. Jerzy Chudek
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Corresponding author

Correspondence to Jerzy Chudek.

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Olszanecka-Glinianowicz, M., Smertka, M., Almgren-Rachtan, A. et al. Ramipril/amlodipine single pill — Effectiveness, tolerance and patient satisfaction with antihypertensive therapy in relation to nutritional status. Pharmacol. Rep 66, 1043–1049 (2014). https://doi.org/10.1016/j.pharep.2014.06.020

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  • DOI: https://doi.org/10.1016/j.pharep.2014.06.020

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