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Impact of Statin Therapy on the Blood Pressure-Lowering Efficacy of a Single-Pill Perindopril/Amlodipine Combination in Hypertensive Patients with Hypercholesterolemia

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Abstract

Introduction

Several lines of research indicate that statins can lower blood pressure (BP) independently of their lipid-lowering effects when used as monotherapy and in combination with antihypertensive agents.

Aim

This short-term, open-label study examined whether statin therapy had a synergistic effect on the BP-lowering efficacy of perindopril/amlodipine in a subgroup of patients in the PERSPECTIVA study with concomitant hypertension and hypercholesterolemia, with or without statin at baseline.

Methods

The PERSPECTIVA study recruited 732 adults with untreated or uncontrolled hypertension. This subgroup analysis of PERSPECTIVA included 587 patients with concomitant hypertension and hypercholesterolemia (mean age 56.7 years) of whom 226 were receiving a statin at baseline (statin [+] group) and 361 were not (statin [−] group). All patients received treatment with single-pill combination perindopril/amlodipine at a dose of 5/5, 10/5 or 10/10 mg/day. The study duration was 60 days with follow-up visits for BP monitoring at 7, 15, 30 and 60 days.

Results

At day 60, BP control (<140/90 mmHg) was significantly greater in the statin [+] vs statin [−] group: 73 vs 64% respectively (+14%, P < 0.05). In the statin [+] group, the single-pill perindopril/amlodipine combination significantly reduced BP in patients previously untreated (n = 18), or treated with monotherapy (n = 97), dual therapy (n = 93), or triple therapy (n = 18): −38.8/−20.0, −39.1/−20.1, −38.0/−19.4, −39.9/−18.3 mmHg respectively (P < 0.001 vs baseline BP). The greatest BP reductions were observed in the first 7 days. Treatment was well tolerated with a similar rate of adverse events in the statin [+] group (0.9%) vs the statin [−] group (2.5%).

Conclusion

BP control rates in patients with uncontrolled hypertension and concomitant hypercholesterolemia are significantly improved with a treatment regimen that combines perindopril/amlodipine with statin therapy, regardless of previous antihypertensive therapy. This subanalysis of the PERSPECTIVA study supports the synergistic BP-lowering effect of statins and perindopril/amlodipine.

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Acknowledgements

This study was supported by Servier, Ukraine. The sponsor was involved in the design and conduct of the study; in the collection, analysis and interpretation of data; and in the preparation, review and approval of this manuscript. Drs Sirenko and Radchenko were supported for writing the study by Servier. Editorial assistance was provided by Jenny Grice and funded by Servier.

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  1. National Scientific Center, Strazhesko Institute of Cardiology, 5, Narodnogo Opolcheniya Street, Kiev, 03680, Ukraine

    Yuriy Sirenko & Ganna Radchenko

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Correspondence to Yuriy Sirenko.

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Sirenko, Y., Radchenko, G. & On behalf of the PERSPECTIVA Study Group. Impact of Statin Therapy on the Blood Pressure-Lowering Efficacy of a Single-Pill Perindopril/Amlodipine Combination in Hypertensive Patients with Hypercholesterolemia. High Blood Press Cardiovasc Prev 24, 85–93 (2017). https://doi.org/10.1007/s40292-017-0184-5

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