The Use of an Amlodipine–Atorvastatin Single Pill Combination in the Management of Hypertension and Hypercholesterolemia: Is Time an Important Problem?

Background: Is the timing of dosing for amlodipine and atorvastatin important with regard to therapeutic efficacy? To answer this question, we designed an outpatient, practice-based, case-control study lasting 8 weeks. Methods: Two hundred patients were divided into two groups: in Group I, patients were provided with a single pill containing amlodipine/atorvastatin (5⁄20 mg) to be taken each night at 10pm, and in Group II, patients were taking amlodipine (5 mg) and atorvastatin (20 mg) each morning at 7am. Results: Our results indicated that no obvious difference was found in blood pressure control between the two groups. Taking amlodipine at night not only lowered blood pressure, but it also provided better control during the peak blood pressure in the morning. Hypercholesterolemia control in the two groups was also not significantly different; taking atorvastatin in the morning was equally as effective as dosing at night in patients with hypercholesterolemia. While the carotid IMT, hs-CRP and LVMI were significantly lower after treatment, no differences were found between the two groups. Although no obvious difference was found in adverse drug reactions between the two groups, compliance was much better in the single-pill group than in patients taking the two medications separately. Conclusion: In conclusion, single-pill amlodipine - atorvastatin taken at night would not only lower the blood pressure but also could reduce the morning peak blood pressure levels the next day. Additionally, this dosing method could improve patients’ adherence to the therapy.