Key result
Perindopril/amlodipine is linked to reduced office blood pressure and ~12% lower hs-CRP in metabolic disease.
Why the study?
The effect of a fixed combination of lipophilic ACEI perindopril and calcium antagonist amlodipine on 24-hour BP profile and systemic inflammation in patients with arterial hypertension and metabolic disorders was assessed.
Does a fixed combination of amlodipine and perindopril improve blood pressure control and systemic inflammation in patients with arterial hypertension and metabolic disorders?
Observational (n=58)
Open-label
No
Does a fixed combination of amlodipine and perindopril improve blood pressure control and systemic inflammation in patients with arterial hypertension and metabolic disorders?
p-value: p=<0.0001
A fixed combination of perindopril and amlodipine effectively lowers blood pressure and reduces systemic inflammation in hypertensive patients with metabolic syndrome or diabetes, though higher doses are often required in diabetic patients.
Perindopril-amlodipine may aid BP control and reduce inflammation in AH with metabolic disorders; leaves open need for randomized confirmation.
Aim: To assess the effect of a lipophilic angiotensin-converting enzyme inhibitor (ACEI) in combination with a calcium antagonist (CA) on the 24-hour blood pressure (BP) profile, systemic inflammation in patients with arterial hypertension (AH) and metabolic disorders (MD). Methods: Fifty-eight patients with the ≥ 2nd degree of AH was divided into 3 groups: patients with AH without metabolic syndrome (MS), patients with AH and MS, and patients with AH and diabetes mellitus (DM). Taking into account the BP profile characteristics, therapy with ACEI perindopril and CA amlodipine in a fixed combination (FC) was prescribed. The observation period for patients was 12 weeks. Results: A profile with an insufficient decrease in BP at night was more often detected in persons with MS having DM and nocturnal hypertension. In patients with AH and DM, the values of daily BP variability exceeded those in persons without MS (P < 0.05). Patients with MS had a higher concentration of high-sensitivity C-reactive protein (hsCRP) compared to patients without MS (3.5 mg/L; P < 0.01). Patients with DM and AH achieved target BP in 60% of cases during treatment: office BP decreased to 134.8 (17.97 kPa) ± 8.7/83.2 (11.09 kPa) ± 6.7 mmHg (∆ = –31/–16 mmHg), 90% of patients required maximum therapeutic doses of antihypertensive therapy (AHT). A decrease in the hsCRP concentration was detected (P < 0.05) in patients of groups 2 and 3, which showed practical possibility of average/maximum therapeutic doses influence on the activity of systemic inflammation (∆ = –12.8% in patients group 2 and ∆ = –11.2% in patients of group 3). Conclusions: A combination of a lipophilic ACEI and a vasoselective СA promotes good BP control, a decrease in the activity of systemic inflammation, and hypersympathicotonia in patients with MD.
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Svistunov et al. (2025) conducted an observational in Arterial hypertension with or without metabolic disorders (n=58). Fixed combination of perindopril and amlodipine vs. Baseline was evaluated on Decrease in office blood pressure (p=<0.0001). A fixed combination of perindopril and amlodipine significantly reduced office blood pressure across all patient groups and decreased high-sensitivity C-reactive protein by 11.2% to 12.8% in patients with metabolic disorders.
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