In high risk hypertensive patients, current ESH/ESC guidelines suggest to initiate treatment with a two-drug combination since the prompt reduction of blood pressure (BP) is translated in those patients into an improvement in cardiovascular (CV) morbidity and mortality. Moreover, in patients with coronary artery disease (CAD) the use of ACEi and calcium channel blockers, not only decrease BP levels but also improve prognosis and symptoms. The aim of this study was to assess the effectiveness, adherence, safety and tolerability of perindopril/amlodipine fixed dose combination in hypertensive patients with CAD during a 4-month treatment.Design and method:
In this multicenter, observational study 1907 hypertensive patients with CAD were prospectively enrolled. The data were recorded from 192 private offices at baseline, at 1 and 4 months of treatment. The adherence to treatment with perindopril/amlodipine fixed dose combination was assessed using the 4-item Morisky Medication-Taking Adherence Scale (MMAS-4) (recorded at the 2nd and 3rd visit).Results:
From 1907 hypertensive patients who participated in the study, 7 patients (0.4% of the sample) prematurely discontinued treatment. Approximately 60% of the patients were male, while mean age was 65.2 ± 10.9 years and mean BMI was 28.2 ± 3.8 kg/m2. The most frequent comorbidities were dyslipidemia (67.3%), diabetes mellitus (29.0%) and metabolic syndrome (21.7%), while 42.3% of the sample was smokers. Mean SBP values decreased from 156.5 ± 15.0 mmHg (1st visit), to 136.2 ± 10.2 mmHg (2nd visit) and 130.8 ± 8.4 mmHg (3rd visit) (p < 0.001). Mean DBP values decreased accordingly from 89.9 ± 9.6 mmHg to 81.3 ± 7.3 mmHg and 78.2 ± 6.4 mmHg (p < 0.001). Adherence to treatment was high in 85.7% of the sample.Conclusions:
Perindopril/amlodipine fixed dose combination decrease promptly and significantly BP levels with high adherence to treatment.