Key result
The combination of perindopril arginine and amlodipine (14/10 mg daily) lowered systolic and diastolic blood pressure significantly more than either monotherapy, with fewer adverse effects.
Why the study?
Does perindopril arginine + amlodipine single-pill combination improve blood pressure reduction compared to monotherapy in hypertensive patients?
Does perindopril arginine + amlodipine single-pill combination improve blood pressure reduction compared to monotherapy in hypertensive patients?
The single-pill combination of perindopril arginine and amlodipine effectively lowers blood pressure more than monotherapy with fewer side effects like ankle edema.
Supports initial perindopril/amlodipine combination therapy; extends RCT evidence favoring fixed-dose regimens over monotherapy in hypertension.
INTRODUCTION: Controlling blood pressure is a global health priority; single-pill combinations of antihypertensive agents are often prescribed to improve adherence, persistence, and outcomes. AREAS COVERED: A novel preparation of perindopril arginine and amlodipine besylate was approved by the US Food and Drug Administration on 21 Jan 2015, based primarily on a 837-subject, 6-week, randomized, multicenter, prospective, clinical trial. The maximal marketed dose of the combination (14/10 mg daily) lowered both systolic and diastolic blood pressure significantly more than either monotherapy, with a reduction in adverse effects (especially ankle edema), compared to amlodipine alone. EXPERT OPINION: Substantial clinical trial experience with amlodipine or perindopril suggests that these two agents effectively lower blood pressure, and may reduce the risk of major adverse cardiovascular events. In the Anglo-Scandinavian Cardiac Outcomes Trial, hypertensive subjects randomized to receive these two drugs (in sequence) had a significantly lower incidence of several types of clinical events, compared to those who received atenolol ± bendroflumethiazide. The new formulation of perindopril arginine protects its ethyl ester, without requiring physical separation from amlodipine in a single pill, and is less hydroscopic than perindopril erbumine. These and other attributes may make this combination an attractive addition to the antihypertensive armamentarium.
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W.J. Elliott (2015) conducted a review in Hypertension (n=837). Perindopril arginine and amlodipine besylate vs. Either monotherapy (amlodipine alone or perindopril alone) was evaluated on Systolic and diastolic blood pressure. The combination of perindopril arginine and amlodipine (14/10 mg daily) lowered systolic and diastolic blood pressure significantly more than either monotherapy, with fewer adverse effects.
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