- In mild-to-severe hypertension, all four incremental doses (3.5/2.5, 7/5, 14/5 and 14/10 mg) of the perindopril/amlodipine single-pill combination (SPC) showed significant improvement in blood pressure (BP) control, BP response and mean BP levels.
- Overall BP-lowering effects with perindopril/amlodipine were similar to irbesartan/hydrochlorothiazide therapy.
Why this matters
- Latest British guidelines recommend a renin-angiotensin system blocker plus a calcium channel blocker as the single optimal combination of drugs and this is one of the combinations ‘preferred’ in European guidance.
- This study included 3270 patients with mild-to-severe hypertension who were randomly assigned to receive 4 incremental doses of perindopril/amlodipine SPC (n=1617) and irbesartan-based regimen (150, 150/12.5, 300/12.5 and 300/25 mg; n=1653).
- Primary endpoint: proportion of patients with controlled BP at each uptitrated dose at 6 months.
- Secondary endpoint: BP response (reduction in systolic and diastolic BP), mean BP levels, 24-hour ambulatory BP measurement (ABPM) and BP variability.
- Funding: Servier.
- BP control rates increased significantly from 21% to 30%, 37% and 42% with each increase in perindopril/amlodipine dose after 1, 2, 3 and 6 months, respectively (P<.005>
- Similarly, BP response rates significantly increased from 47%, 62%, 68% and 73% at 1, 2, 3 and 6 months, respectively (P<.001>
- After 6 months, mean BP level was reduced from 163.7/91.4 mmHg at baseline to 138.9/80.6 mmHg.
- No significant difference was seen in 24-hour ABPM in patients who received irbesartan-based and perindopril/amlodipine therapy, but perindopril/amlodipine reduced BP variability vs irbesartan-based therapy.