PMC Unauthorized use of these marks is strictly prohibited. 4b). The therapeutic effect of PER/IND/AML was associated with improvements in health-related quality of life (HR-QOL) in hypertensive patients, as assessed by the 36-Item Short Form Survey [50] or the World Health Organization Quality-of-Life Scale (WHOQOL-BREF) [43]. Addition of an ACE inhibitor to a dihydropyridine CCB may also reduce the risk of CCB-associated peripheral edema in comparison to a high-dose CCB monotherapy, thereby improving tolerability of the antihypertensive treatment [11]. Eleven patients only came to the enrollment visit and were never followed up, while another 33 patients were lost to follow-up or have incomplete data, so, in total, data of 44 patients (2.4%) were not available for analysis. The antihypertensive efficacy of the triple fixed combination of perindopril, indapamide, and amlodipine: The results of the PETRA study. All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. In fact, the highest reduction in blood pressure occurred within the first 4weeks of treatment (Fig. Topouchian J, Mourad JJ, De Champvallins M, et al. Prevention of cardiovascular events with an antihypertensive regimen of amlodipine adding perindopril as required versus atenolol adding bendroflumethiazide as required, in the Anglo-Scandinavian Cardiac Outcomes Trial-Blood Pressure Lowering Arm (ASCOT-BPLA): a multicentre randomised controlled trial. The mean time until dose increase was 32.911.8days. 2.4) [12]. Perindopril/Indapamide/Amlodipine in Hypertension: A Profile of Its Use. official website and that any information you provide is encrypted However, the dynamics of changes in TOD were different between the two groups, which should be taken into consideration during management of patients with and without IHD. Adherence was assessed by the Hill-Bone medication adherence scale. 2022 Mar;22(2):219-230. doi: 10.1007/s40256-022-00521-0. A fixed-dose combination of perindopril/amlodipine shows significant blood pressure reduction and improvement in medication adherence in a primary care setting. brahm G, Dzsi CA. In addition, treatment with perindopril/amlodipine was associated with a significant increase in patients adherence as compared to previous antihypertensive treatment. The most frequently preexisting medication consisted of ACE inhibitors (58.3%), betablockers (33.0%), calcium channel blockers (25.1%), AT1 receptor blockers (19.9%), and thiazides/thiazide analogues (18.9%) (Fig. A Correction to this paper has been published: 10.1007/s40256-022-00535-8, National Library of Medicine Of the 1770 patients, 803 (45.4%) were previously untreated, whereas 967 (54.6%) were previously on antihypertensive treatment. He armed himself with a balaclava, latex gloves, condoms and Viagra pills and posed as a cab driver in a Mercedes to roam the streets of Brighton, East Sussex. Cough, a well-known class effect of ACE inhibitors, is less frequent with PER than with other drugs in this class, and it can be mitigated by the addition of a CCB, such as AML [59]. In the present study, perindopril/amlodipine showed a favorable safety and tolerability profile across a broad range of ambulatory patients with different ages, comorbidities and co-medications. Furthermore, the proportion of patients with severe hypertension European Society of Hypertension/European Society of Cardiology (ESH/ESC) grade II or III decreased from 64.4 to 3.9%, and patients with pre-existing isolated systolic hypertension (n=284) converted to normal BP in 67.6% of cases. Ambulatory and home BP measurements have stronger prognostic evidence than office BP measurements because they can identify patients with white coat, masked, morning and night-time hypertension, as well as those with BP variability [4, 57]. Susanne V. Fleig and Hermann Haller have nothing to disclose. Epub 2015 Sep 9. 5). Where reported, Morisky Medication Adherence scale scores significantly (p<0.05) increased over 3 months treatment with the SPC [38, 41]. In the subgroup of patients <65years of age, systolic blood pressure decreased significantly (mean difference: 30.6/16.2mmHg; p<0.0001 vs. baseline, n=1133) (Fig. government site. In 25% of patients, three antihypertensive agents are required to achieve BP control [2]. PER/IND/AML reduced LVMI in patients with hypertension [37, 40, 48]. In an open-label trial (PRECIOUS), PER/IND/AML 4/1.25/5mg was effective in patients with uncontrolled hypertension and PER/AML 4/5 mg was effective in those with newly diagnosed or uncontrolled hypertension [44]. Trends in antihypertensive medicatrion use and blood pressure control among adults with hypertension in Germany. PRECIOUS trial confirms safety and efficacy of guideline's single-pill combination strategy. Gradman AH, et al. Ethical approval was granted by the independent ethics commission in Freiburg/Germany (FEKI). Thacker H, Konda Reddy KM, Murthy LS, et al. PER/IND/AML, with its 24-h duration of action, preserves the physiologic circadian BP pattern by reducing BP variability. Vlachopoulos C, Aznaouridis K, O'Rourke MF, et al. Careers. A comparable decrease was observed in patients 65years and older (mean difference: 29.1/13.0mmHg; p<0.0001 vs. baseline, n=636) (Fig. Abstract. At study entry, 21.3% of patients (n=377) had grade 3 hypertension, 51.1% (n=905) grade 2 hypertension and 26.1% (n=462) grade 1 hypertension according to the ESH/ESC guidelines [2] (Fig. Efficacy and tolerability of a fixed combination of perindopril/amlodipine/indapamide in patients with essential hypertension: pilot study. This article reviews the efficacy and tolerability of perindopril/amlodipine FDC and briefly summarizes the agent's pharmacologic properties. Efficacy of fixed dose of triple combination of perindopril-indapamide-amlodipine in obese patients with moderate-to-severe arterial hypertension: an open-label 6-month study. In the total study population, 1720 patients completed the 3months follow-up and an additional 50 patients were seen at least for one additional control visit. The mean age was 62.812.8years in the subgroup of previously treated patients and 56.613.3years in the untreated population. After about 3months of treatment with perindopril/amlodipine, mean values of systolic and diastolic blood pressure were significantly reduced, from 163.6/95.4 to 133.6/80.3mmHg in the total population and from 161.9/94.2 to 134.1/80.4mmHg in previously treated patients. The rate of ADR (<4.9%), especially of serious ADR (<0.5%), was low, e.g., angioedema was reported in only 1 patient (0.06%). PER, IND and AML as monotherapies and as two-drug SPCs (PER/IND, PER/AML, IND/AML) have long been available, and are routinely prescribed by healthcare practitioners for the treatment of hypertension. Furthermore, perindopril/amlodipine FDC was associated with a numerically lower incidence of peripheral edema compared with amlodipine monotherapy. Main outcomes measure: The primary outcomes were the mean change in BP from baseline and the proportion of patients achieving adequate BP control (</=140/90 mmHg, or </=130/80 mmHg in patients with diabetes mellitus) in the intent-to-treat (ITT) population. 4b). 2b). In a subsequent 6-month, randomized, open-label trial, PER/IND/AML was associated with greater BP control (80% vs 58% at 3 months; 85% vs 53% at 6 months; p<0.05 for both) and a better ambulatory BP profile in general (Table (Table3)3) than the equivalent-dose free combination in obese patients with moderate to severe hypertension uncontrolled on dual therapy (n=75) [33]. Taken together, the present results indicate that perindopril/amlodipine is a suitable treatment option for hypertensive patients in routine medical practice. Disclaimer. Nedogoda SV, Stojanov VJ. The therapeutic effect of PER/IND/AML was associated with improved health-related quality of life. Please enable it to take advantage of the complete set of features! achieved target values <140/90mmHg. and transmitted securely. Conclusions: During the 3 months of the PETRA study, the outstanding 24-h antihypertensive efficacy of the triple fixed combination of perindopril, indapamide, and amlodipine was confirmed both by office BP readings and by ABPM recordings. High Blood Press Cardiovasc Prev. Kamasova M, Vaclavik J, Kocianova E, et al. The efficacy of PER/IND/AML was confirmed by central BP measurements in one study; the mean change from baseline in central SBP/DBP at 5 months was 24.7/ 11.8 mmHg (p0.001 for both SBP and DBP), with 86.7% and 90% of patients achieving target central SBP and DBP, respectively [39]. Furthermore, central BP is considered a better predictor of cardiovascular events than brachial BP [58]. PER/IND effectively reduced BP in several placebo-controlled and active comparator (losartan, atenolol, irbesartan) trials in patients with hypertension, including elderly patients and those with kidney function impairment [26]. The positive influence on adherence may be of special relevance for patients with comorbidities and co-medications as well as for previously insufficiently treated patients. A betablocker was newly commenced during our observation in 42 patients (2.3%), a loop diuretic in 10 patients (0.6%), a thiazide in 23 patients (1.3%). The most common reasons given by treating physicians for switching patients on antihypertensive medication to perindopril/amlodipine SPC were insufficient blood pressure control (81.0%), intolerability (15.2%) or non-adherence to the previous medication (12.1%). Hypertension in adults: diagnosis and management. Changes in blood pressure in patient subgroups. The SPC was also associated with more frequent use of lower dose levels and lesser use of maximal doses for BP control, compared with the free combination [33]. At tissue level, perindoprilat predominantly acts on vascular wall and the kidney, with no salt and water retention or reflex tachycardia during chronic treatment. Julius S, Kjeldsen SE, Weber M, et al. Mean 24h BP (n=167) was reduced from 150.612.6/88.98.8 to 132.411.9/79.48.5mmHg (p<0.0001). MacMahon S, et al. These findings were supported by a prospective clinical study in obese patients with hypertension and T2DM (n=87) [45]. Missed Dose Triple-component SPC PER/IND/AML provided better antihypertensive efficacy, with other beneficial outcomes, compared with free combination of the same agents in patients with uncontrolled hypertension, including those with comorbid T2DM and obesity [33, 34, 45]. Study data were analyzed by an independent statistical institute, ANFOMED GmbH, Mhrendorf, Germany, and both were funded by Servier Deutschland GmbH. Vhody smoothies zvisia od toho, o do nich dte. In the subgroup of patients with previous antihypertensive treatment, systolic blood pressure decreased significantly from 161.914.4 to 134.111.9mmHg and diastolic blood pressure from 94.29.2 to 80.47.4mmHg at the final examination (27.8/13.9; p<0.0001 vs. baseline) (Fig. Treatment of hypertension in patients 80 years of age or older. As a library, NLM provides access to scientific literature. 3b). Office DBP decreased from 95.49.4 to 80.37.7mmHg. In clinical practice, switching to PER/IND/AML was associated with a significant (p0.001) reduction in the number of antihypertensive tablets taken per day (3.3 vs 1.2) [53]. Haria M, Wagstaff AJ. In the total study population, 88.0% of patients had concomitant risk factors and/or disease, the most common being dyslipidemia (52.8%), obesity (33.9%), tobacco use (33.0%) and diabetes mellitus (20.8%). Therefore, switching from PER/IND + AML to PER/IND/AML reduces pill burden and simplifies the treatment regimen, which may improve adherence to treatment, leading to better BP control and clinical outcomes. Background: Fixed-dose combination treatments using an angiotensin-converting enzyme (ACE) inhibitor, such as perindopril, plus a calcium channel blocker (CCB), such as amlodipine, have been endorsed by guidelines because they improve blood pressure control and cardiovascular outcomes in hypertensive patients, while being well tolerated and well adhered to by patients. Most patients (87.8%) had additional cardiovascular risk factors and/or diseases. (Fig.1).1). However, complex treatment regimens and high pill burden reduce treatment adherence, which in turn leads to poor BP control. The antihypertensive efficacy of the triple fixed combination of perindopril, indapamide, and amlodipine: the results of the PETRA Study. Amlodipine: a reappraisal of its pharmacological properties and therapeutic use in cardiovascular disease. Blood pressure in Germany 20082011: results of the German Health Interview and Examination Survey for Adults (DEGS1). Baseline values of blood pressure and heart rate in patients with and without previous antihypertensive therapy were in a similar rangethe previously treated group had a systolic blood pressure (SBP) of 161.914.4mmHg, diastolic blood pressure (DBP) of 94.29.2mmHg and a heart rate of 76.7/min10.0; treatment-naive patients had a SBP of 165.715.1mmHg, a DBP of 96.89.4mmHg and a heart rate of 78/min10.1 (differences not significant; Table2). Smoothie. Effect of amlodipine on the progression of atherosclerosis and the occurrence of clinical events. 1b). Simpson SH, Simpson SH, Eurich DT, Majumdar SR, et al. A major focus of the present study was to evaluate the effects of perindopril/amlodipine in untreated patients versus previously treated patients who required a change in antihypertensive medication. and transmitted securely. Development and testing of the Hill-Bone Compliance to High Blood Pressure Therapy Scale. Napumpujte ho antioxidantmi a vitamnmi! In prospective noncomparative studies, PER/IND/AML effectively reduced BP in patients with grade IIII uncontrolled hypertension, including those with comorbid T2DM, metabolic disorders or a high cardiovascular risk (Table (Table2)2) [3740, 43]. Reducing BP variability use of these marks is strictly prohibited in Freiburg/Germany ( FEKI ) E, et al in. 22 ( 2 ):219-230. doi: 10.1007/s40256-022-00521-0 furthermore, perindopril/amlodipine FDC and briefly summarizes agent... 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