Key result
Single-pill amlodipine/atorvastatin was associated with a significantly greater relative reduction in 10-year hard coronary heart disease risk (24.5%) compared with amlodipine monotherapy (14.4%) or co-prescribed amlodipine and statin (18.4%).
Why the study?
Does single-pill amlodipine/atorvastatin improve estimated 10-year CHD risk reduction and dual BP/LDL-C goal attainment compared to amlodipine monotherapy or co-prescribed amlodipine and statin in patients with hypertension?
Cohort (n=3,619)
Yes
Does single-pill amlodipine/atorvastatin improve estimated 10-year CHD risk reduction and dual BP/LDL-C goal attainment compared to amlodipine monotherapy or co-prescribed amlodipine and statin in patients with hypertension?
Single-pill amlodipine/atorvastatin improves estimated 10-year CHD risk reduction and dual BP/LDL-C goal attainment compared to separate prescriptions or monotherapy in real-world practice.
May support single-pill combinations in real-world hypertension; hypothesis-generating and requires randomized outcome trials.
Hypertension and dyslipidemia are highly co-prevalent, but often poorly controlled, coronary heart disease (CHD) risk factors. A retrospective cohort study was conducted between January 2004 and April 2008 to compare estimated 10-year CHD risk reduction and dual blood pressure and low-density lipoprotein cholesterol goal attainment (Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure and Third Report of the National Cholesterol Education Program Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults [Adult Treatment Panel III]) in patients with a first prescription for amlodipine monotherapy, co-prescribed amlodipine + statin, or single-pill amlodipine/atorvastatin. In total, 2739 patients were prescribed amlodipine monotherapy, 653 were co-prescribed amlodipine + statin, and 227 were prescribed single-pill amlodipine/atorvastatin. Baseline CHD risk was similar in all 3 cohorts (11.0%-12.5%). Relative CHD risk reduction was greater in those prescribed single-pill amlodipine/atorvastatin (24.5%) compared with amlodipine monotherapy (14.4%, P<.01), and co-prescribed amlodipine + statin (18.4%, P=.01). The findings were driven by greater dual goal attainment for patients prescribed single-pill amlodipine/atorvastatin (50.2%) compared with amlodipine monotherapy (31.7%, P<.05) and co-prescribed amlodipine + statin (37.5%, P<.05).
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Neutel et al. (2010) conducted a cohort in Hypertension and dyslipidemia (n=3,619). Single-pill amlodipine/atorvastatin vs. Amlodipine monotherapy or co-prescribed amlodipine + statin was evaluated on Change in Framingham 10-year risk of a hard coronary end point (myocardial infarction and coronary death) (p=<0.01). Single-pill amlodipine/atorvastatin was associated with a significantly greater relative reduction in 10-year hard coronary heart disease risk (24.5%) compared with amlodipine monotherapy (14.4%) or co-prescribed amlodipine and statin (18.4%).
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