Effectiveness and Safety of Fixed-Dose Combination Perindopril + Amlodipine in Hypertensive Patients Received Treatment Outpatiently

Yu.N. Sirenko, A.D. Radchenko


The aim of this study was to evaluate the possibility and safety of fixed-dose combination (FDC) perindopril/amlodipine as initial therapy for treatment of patients with newly onset or hypertension uncontrolled by previous treatment (HT) and to assess the intensity of treatment prescribed by doctors in general practice.
The study included 4,424 patients with varying degrees of high blood pressure (BP), which met the inclusion criteria and had no exclusion criteria. All patients were treated by general practitioners outpatiently. The mean age was 60.0 ± 11.4 years (35.4/64.6 % — male/female). All patients underwent measurement of office BP and heart rate in the monitoring phase. FDC was administered in doses of 5/5, 10/5, 5/10 and 10/10 mg, if necessary indapamide retard has been added. The duration of treatment was 2 months.
Prescription of FDC for 2 months resulted in a significant decrease in systolic (SBP) and diastolic blood pressure (DBP) by 34.3 and 16.1 mmHg and achievement of their target levels in 63 % of patients. Efficiency of treatment depended on the initial level of BP — the higher it was, the greater was the degree of reduction and fewer target level — 25.9/14.2 mmHg and 78.6 %, 37.6/16.6 mmHg and 54.3 %, 56.4/21.4 mmHg and 33.7 % in initial SBP level 140–159, 160–179, and > 180 mmHg respectively. The highest frequency of achieving target BP against FDC were in patients who had not been treated previously — 73.2 %, slightly lower in those treated with one drug (from 63.8–68.2 %) and with combination (48.7–59 %). This study demonstrated the existence of some inertia among physicians in the treatment of hypertensive patients — despite the lack of achievement of target levels of blood pressure in half of the patients have not been increased doses of FDC components or indapamide retard has not been added. Treatment with FDC was well tolerated, leading to adverse reactions only in 0.9 % of patients. Of all adverse events cough (0.2 %) and peripheral edema (0.2 %) were more common. There were no serious adverse events. FDC withdrawal due to adverse events was only in 11 patients (0.25 %) patients.
Thus, the antihypertensive efficacy and safety of FDC perindopril + amlodipine has been confirmed in a broad range of hypertensive patients and demonstrated the existence of a certain inertia among physicians in the intensity of managing patients with hypertension and especially with severe hypertension.


hypertension; blood pressure control; fixed-dose combination


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