Key result
Perindopril monotherapy produced a significant blood pressure decrease of 14.9/8.4 mm Hg from baseline at 12 weeks, achieving BP control in 40.0% of patients.
Why the study?
Does perindopril reduce blood pressure in patients nonresponsive to previous antihypertensive therapy?
Does perindopril reduce blood pressure in patients nonresponsive to previous antihypertensive therapy?
Perindopril monotherapy (4-8 mg/d) effectively reduces blood pressure and is well tolerated in patients who are nonresponsive to previous antihypertensive therapy.
Answers are grounded in this paper and cite their sources.
May support perindopril in nonresponders; leaves open randomized confirmation.
A subgroup analysis of a large US community trial was conducted to evaluate the antihypertensive efficacy and safety of perindopril, an angiotensin-converting enzyme inhibitor (ACEI), in 3159 patients who lacked blood pressure (BP) control at entry with previous antihypertensive therapy. Patients received 4 mg perindopril daily for 6 weeks. Based on physicians' assessment of BP response, the patients were then either maintained on 4 mg daily (group 1) or the dose was increased to 8 mg daily (group 2) for an additional 6 weeks. The mean baseline sitting BP was 158.2/92.9 mm Hg. Perindopril monotherapy produced a significant BP decrease from baseline of 11.6/6.5 mm Hg and 14.9/8.4 mm Hg at weeks 6 and 12, respectively. In group 1 patients, the majority of BP decrease occurred at week 6 (17.3/9.5 mm Hg) and was maintained until the end of week 12 (18.2/10.1 mm Hg). In group 2 patients, the BP decrease on the 4-mg dose was modest at week 6 by 5.2/3.1 mm Hg. However, further dose up-titration of perindopril to 8 mg resulted in a clinically significant BP decrease of 11.9/6.8 mm Hg from baseline to week 12. Significant antihypertensive effects of perindopril were also demonstrated in the special patient populations of elderly (>or=65 years), black, isolated systolic hypertension, patients with concomitant cardiovascular diseases, and patients nonresponsive to other ACEI therapy. Overall, BP control (<140/<90 mm Hg) was achieved in 40.0% of patients at week 12. Perindopril was well tolerated with cough and angioedema reported in 8.5% and 0.4% patients, respectively. Physicians assessed therapeutic response to perindopril as satisfactory in 73.8% patients who were nonresponsive to previous antihypertensive therapy. These results suggest that, in a community-based practice, perindopril monotherapy (4-8 mg/d) is an effective and safe therapeutic option in patients nonresponsive to previous antihypertensive therapy.
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Guo et al. (2004) studied Hypertension (n=3,159). Perindopril was evaluated on Blood pressure decrease from baseline at week 12 (14.9/8.4 mm Hg decrease). Perindopril monotherapy produced a significant blood pressure decrease of 14.9/8.4 mm Hg from baseline at 12 weeks, achieving BP control in 40.0% of patients.
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