Effectiveness and Adherence to Treatment with Perindopril/Indapamide/Amlodipine Single-Pill Combination in a Greek Population with Hypertension
- 89 Downloads
Despite the overwhelming evidence and the established benefits of antihypertensive treatment, adherence to treatment remains low.
To assess the adherence to treatment with a perindopril/indapamide/amlodipine single-pill combination (SPC), its effectiveness on blood pressure (BP) reduction, as well as the safety and tolerability of this SPC over a 4-month treatment period.
This multicenter, non-interventional study prospectively included 2285 hypertensive patients on perindopril/indapamide/amlodipine SPC. The data were recorded at baseline, 1 month, and 4 months.
Of the 2285 hypertensive patients included in the study, 50.5% were at “high/very high risk”. Mean systolic (SBP)/diastolic (DBP) decreased from 162.3 ± 13.3/93.1 ± 9.3 mmHg at baseline to 129.7 ± 8.3/78.6 ± 7.1 mmHg at 4 months (p < 0.001). Patients with higher baseline BP levels showed greater BP reduction. Patients with hypertension stages 1, 2, and 3 showed mean SBP/DBP reductions of 21.5/10.4 mmHg, 34.2/14.7 mmHg, and 51.2/22.5 mmHg, respectively, at study end (p < 0.001). Only 26 patients (1.1%) prematurely discontinued treatment (0.58% due to an adverse reaction or event).
Perindopril/indapamide/amlodipine SPC decreased BP levels rapidly and significantly. The degree of BP reduction was associated with the severity of hypertension and/or with total cardiovascular risk at baseline. Simplifying the drug regimen by using this SPC improved adherence and showed excellent tolerability.
Compliance with Ethical Standards
This study was funded by Servier Hellas.
Conflict of interest
K. Tsioufis, S. Douma, A.J. Manolis, and M.S. Kallistratos received a research grant from Servier Hellas Pharmaceuticals Ltd. Servier Hellas Pharmaceuticals Ltd was not involved in the collection and interpretation of data, in the writing of the manuscript, or in the decision to submit the manuscript for publication. The authors have no other conflicts of interest with regard to the content of this article.
All procedures in this study were in accordance with the 1964 Helsinki declaration and its amendments, and the Ethics Committee or institutional review board that approved the study.
Written informed consent obtained from patients.
- 3.Yoon SS, Carroll MD, Fryar CD. Hypertension prevalence and control among adults: United States, 2011–2014. NCHS Data Brief. 2015;220:1–8.Google Scholar
- 8.Frank J. Managing hypertension using combination therapy. Am Fam Physician. 2008;77:1279–86.Google Scholar
- 10.Cushman W, Ford C, Cutler J, Margolis K, Davis B, Grimm R, et al. Success and predictors of blood pressure control in diverse North American settings: the antihypertensive and lipid-lowering treatment to prevent heart attack trial (ALLHAT). J Clin Hypertens (Greenwich). 2002;4:393–404.CrossRefGoogle Scholar
- 11.Mancia G, Fagard R, Narkiewicz K, Redon J, Zanchetti A, Böhm M, et al. 2013 ESH/ESC Guidelines for the management of arterial hypertension: the Task Force for the management of arterial hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). Eur Heart J. 2013;34:2159–219.CrossRefGoogle Scholar
- 14.Mourad JJ, Amodeo C, de Champvallins M, Brzozowska-Villatte R, Asmar R, Study coordinators, investigators. Blood pressure-lowering efficacy and safety of perindopril/indapamide/amlodipine single-pill combination in patients with uncontrolled essential hypertension: a multicenter, randomized, double-blind, controlled trial. J Hypertens. 2017;35(7):1481–95. https://doi.org/10.1097/hjh.0000000000001359.CrossRefGoogle Scholar
- 27.Selak V, Elley CR, Bullen C, Crengle S, Wadham A, Rafter N, et al. Effect of fixed dose combination treatment on adherence and risk factor control among patients at high risk of cardiovascular disease: randomised controlled trial in primary care. BMJ. 2014;27(348):g3318. https://doi.org/10.1136/bmj.g3318.CrossRefGoogle Scholar