Effectiveness of an amlodipine and perindopril arginine-based strategy for hypertension management in Morocco: a prospective observational study

Introduction: hypertension is a leading cause of cardiovascular disease and mortality in Morocco, with many patients remaining uncontrolled on monotherapy. This study evaluated the effectiveness and safety of adding perindopril arginine to amlodipine for better blood pressure (BP) control among patients with hypertension in Morocco. Methods: this multicentre, prospective observational study enrolled 1,614 patients with hypertension who were previously uncontrolled on amlodipine monotherapy and were prescribed perindopril. Baseline characteristics, BP measurements, and adverse events were monitored over 90 days. Results: participants had a mean age of 63.1 ± 11.2 years, with 66.5% being women. Significant BP reductions were observed from baseline to day 90: mean systolic BP decreased from 171.3 mmHg to 128.7 mmHg (mean difference: -42.6 mmHg, p<0.0001) and mean diastolic BP from 92.4 mmHg to 74.6 mmHg (mean difference: -17.8 mmHg, p<0.0001). BP control (<140/90 mmHg) increased from 60.0% of patients at day 30 to 91.3% at day 90 (p<0.0001). Safety assessments indicated minimal adverse events, with incidence decreasing over the study period. By day 90, only 0.25% of participants reported adverse events, including hypotension (0.06%), fatigue (0.06%), and headaches (0.06%). No serious adverse events were reported. Conclusion: Moroccan patients with hypertension treated with a combination of amlodipine and perindopril arginine showed a significant improvement in BP control and a favourable safety profile. This strategy presents a promising approach for managing hypertension in similar populations.