Skip to main content
Hauptrubriken
CME Facharzt-Training Webinare Zeitschriften Bücher e.Medpedia Podcast
Service
Jobbörse Info & Hilfe
Fachgebiete
Anästhesiologie Allgemeinmedizin Arbeitsmedizin Augenheilkunde Chirurgie Dermatologie Gynäkologie und Geburtshilfe HNO Innere Medizin Kardiologie Neurologie Onkologie und Hämatologie Orthopädie und Unfallchirurgie Pädiatrie Pathologie Psychiatrie Radiologie Rechtsmedizin Urologie Zahnmedizin
Themen
Typ-2-Diabetes und Adipositas Klimawandel und Gesundheit Neues aus dem Markt COVID-19 Praxis und Beruf Seltene Erkrankungen GOÄ & EBM Panorama
Sammlungen
Kasuistiken Algorithmen & Infografiken Blickdiagnosen Arthropedia FlapFinder (für Dermatochirurgen) Videos Kongressberichterstattung Medizin für Apothekerinnen und Apotheker Für Ärztinnen und Ärzte in Weiterbildung Für Medizinstudierende

Die Highlights vom Kongress des American College of Cardiology 2024

Im April diskutierten die Herz-Kreislauf-Spezialisten aus der ganzen Welt auf dem  Kongress des American College of Cardiology (ACC) u.a. neue Therapieansätze bei akutem Myokardinfarkt, koronarer Herzerkrankung, kardiogenem Schock oder Aortenklappenstenose. In unserem Kongress-Dossier haben wir für Sie Berichte über die „Late-Breaking Trials“ und andere wichtige Studien zusammengestellt. 
Erweiterte Suche
Anmelden
nach oben
High Blood Pressure & Cardiovascular Prevention
Erschienen in: High Blood Pressure & Cardiovascular Prevention 4/2015

01.12.2015 | Original Article

Effectiveness of Fixed-Dose Perindopril/Amlodipine on Clinic, Ambulatory and Self-Monitored Blood Pressure and Blood Pressure Variability: An Open-Label, Non Comparative Study in the General Practice

verfasst von: Yuri A. Karpov, Vladimir M. Gorbunov, Alexander D. Deev

Erschienen in: High Blood Pressure & Cardiovascular Prevention | Ausgabe 4/2015

Einloggen, um Zugang zu erhalten

Abstract

Introduction

Fixed-dose combinations (FDCs) of antihypertensive agents improve therapeutic efficacy, according to current guidelines and large clinical studies.

Aim

This Russian study examined the effect on blood pressure (BP) of substituting current ineffective antihypertensive treatment with FDC perindopril/amlodipine in patients with uncontrolled hypertension.

Methods

BP was measured in the doctor’s office at each visit, daily at home, and by ambulatory monitoring (ABPM) at inclusion and end-of-study.

Results

Ninety patients (52.7 ± 12.2 years old; mean baseline BP 161.4/94.9 mmHg) at high or very high cardiovascular risk were included. FDC perindopril/amlodipine (5/5, 10/5 or 10/10 mg) exerted a rapid (2 weeks) and significant (p < 0.001) reduction in clinic BP, maintained after 3 months (−33.7/17.1 mmHg). ABPM and home monitoring showed that BP decrease remained significant throughout the study (p < 0.0001). BP variability was reduced, indicating the stable and homogeneous 24-h antihypertensive effect of FDC perindopril/amlodipine. Quality of life and adherence were also improved.

Conclusions

The three main methods of BP assessment showed that substituting ineffective antihypertensive therapy with FDC perindopril/amlodipine resulted in a rapid and pronounced antihypertensive effect, with target BP levels achieved after 3 months in most patients. This beneficial effect was observed also on various parameters related to BP variability, which may reflect additional cardioprotective properties.
Literatur
1.
2.
Harmon L, Chilton RJ, Spellman C. Reducing cardiovascular events and end-organ damage in patients with hypertension: new considerations. Postgrad Med. 2011;123(2):7–17.CrossRefPubMed
3.
Mancia G, Fagard R, Narkiewicz K, et al. 2013 ESH/ESC guidelines for the management of arterial hypertension: the Task Force for the Management of Arterial Hypertension of ESH and of ESC. Eur Heart J. 2013;34(28):2159–219.CrossRefPubMed
4.
Go AS, Bauman MA, King SMC, et al. An effective approach to high blood pressure control. A science advisory from AHA, ACC, and the Centers for Disease Control and Prevention. Hypertension. 2014;63(4):878–85.CrossRefPubMed
5.
James PA, Oparil S, Carter BL, et al. 2014 Evidence-based guideline for the management of high blood pressure in adults: report from the panel members appointed to the Eighth Joint National Committee (JNC 8). JAMA. 2014;311(5):507–20.CrossRefPubMed
6.
Clement DL, De Buyzere ML, De Bacquer DA, et al. Prognostic value of ambulatory blood-pressure recordings in patients with treated hypertension. New Engl J Med. 2003;348:2407–15.CrossRefPubMed
7.
Dolan E, Stanton AV, Thom S, et al. Ambulatory blood pressure monitoring predicts cardiovascular events in treated hypertensive patients—an Anglo-Scandinavian cardiac outcomes trial substudy. J Hypertens. 2008;27:876–85.CrossRef
8.
Rothwell PM, Howard SC, Dolan E, et al. Prognostic significance of visit-to-visit variability, maximum systolic blood pressure and episodic hypertension. Lancet. 2010;375:895–905.CrossRefPubMed
9.
Oganov RG, Timofeev TN, Koltunov IE, et al. Epidemiology of hypertension in Russia. The results of 2003–2010 federal monitoring. Cardiovasc Ther Prev. 2011;10:9–13.
10.
Dallongeville J, Banegas JR, Tubach F, et al., For the EURIKA Study. Survey of physicians’ practices in the control of cardiovascular risk factors: the EURIKA study. Eur J Prev Cardiol. 2012;19(3):541–50.
11.
Prugger C, Keil U, Wellman J, et al., For the EUROASPIRE III. Blood pressure control and knowledge of target blood pressure in coronary patients across Europe: results from the EUROASPIRE III survey. J Hypertens. 2011;29(8):1641–8.
12.
Bramlage P, Böhm M, Volpe M, et al., For the ISEARCH Study. A global perspective on blood pressure treatment and control in a referred cohort of hypertensive patients. J Clin Hypertens (Greenwich). 2010;12(9):666–77.
13.
Tocci G, Ferrucci A, Pontremoli R, et al. Blood pressure levels and control in Italy: comprehensive analysis of clinical data from 2000–2005 and 2005–2011 hypertension surveys. J Hum Hypertens. 2015. doi:10.​1038/​jhh.​2015.​4.
14.
Karpov YA, Deev AD, On behalf of the doctors participating in the program PRORYV. Uncontrolled hypertension—new opportunities in solving the problem of increasing the effectiveness of treatment. Kardiologija. 2012;2:29–35.
15.
Russian Medical Society of Hypertension, Russian Scientific Society of Cardiology. Diagnosis and treatment of hypertension. Russian recommendations (fourth revision); 2010.
16.
Longo D, Toffanin G, Garbelotto R, et al. Performance of the UA-787 oscillometric blood pressure monitor according to the European Society of Hypertension protocol. Blood Press Monit. 2003;8(2):91–5.CrossRefPubMed
17.
Rogoza AN, Nikolsky VP, Oshchepkova EV, et al. Ambulatory blood pressure monitoring in hypertension: methodological issues; 2005.
18.
Rizzoni D, Castellano M, Muiesan ML. Beyond trough-to-peak ratio: a new index of the smoothness of the antihypertensive effect of a drug. High Blood Press. 1997;6:110–5.
19.
Morisky DE, Green LW, Levine DM. Concurrent and predictive validity of a self-reported measure of medication adherence. Med Care. 1986;24(1):67–74.CrossRefPubMed
20.
Morisky DE, Ang A, Krousel-Wood M, Ward HJ. Predictive validity of a medication adherence measure in an outpatient setting. J Clin Hypertens (Greenwich). 2008;10(5):348–54.CrossRef
21.
Sever PS, Dahlof B, Poulter NR, et al., ASCOT Investigators. Prevention of cardiovascular events with an antihypertensive regimen of amlodipine adding perindopril as required versus atenolol adding bendroflumethiazide as required, in the Anglo-Scandinavian Cardiac Outcomes Trial (ASCOT-BPLA): a multicenter randomized controlled trial. Lancet. 2005;366(9489):895–906.
22.
Rodriguez-Granillo GA, Vos J, Bruining N, et al., Investigators of the EUROPA Study. Long-term effect of Perindopril on coronary atherosclerosis progression (from the PERindopril’s Prospective Effect on Coronary aTheroslerosis by Angiography and IntraVascular Ultrasound Evaluation [PERSPECTIVE] Study). Am J Cardiol. 2007;100(2):159–63.
23.
Tropeano AI, Boutouyrie P, Pannier B, et al. Brachial pressure-independent reduction in carotid stiffness after long-term angiotensin-converting enzyme inhibition in diabetic hypertensives. Hypertension. 2006;48:80–6.CrossRefPubMed
24.
Williams B, Lacy PS, Thom SM, et al., CAFE Investigators, Anglo-Scandinavian Cardiac Outcomes Trial Investigators, CAFE Steering Committee and Writing Committee. Differential impact of blood pressure-lowering drugs on central aortic pressure and clinical outcomes principal results of the conduit artery evaluation (CAFE) study. Circulation. 2006;113(9):1213–25.
25.
Kobalava ZhD, Kotovskaya Y, Lukyanova L, et al. Combination therapy of hypertension fixed combination of perindopril arginine/amlodipine in clinical practice: the organization and the main results of the program KONSTANTA. Kardiologija. 2013;6:25.
26.
Bahl VK, Jadhav UM, Thacker HP. Management of hypertension with the fixed combination of perindopril and amlodipine in daily clinical practice. Results from the STRONG prospective, observational, multicenter study. Am J Cardiovasc Drugs. 2009;9(3):135–42.CrossRefPubMed
27.
Hatala R, Bachanova K, Sidlo R, SYMBIO Investigators. SYMBIO: results of a longitudinal study of optimized blood pressure lowering therapy with fixed combination perindopril/amlodipine. J Hypertens. 2010;28:e98–9.CrossRef
28.
Karpov YA. Achieving the target blood pressure in patients with hypertension uncontrolled when translating from mono- or combination therapy for a fixed combination of an ACE inhibitor and a calcium antagonist. Arter Hypertens. 2012;18(6):484.
29.
Boggia J, Li Y, Thijs L, et al. Prognostic accuracy of day vs. night ambulatory blood pressure: a cohort study. Lancet. 2007;370(9594):1219–29.CrossRefPubMed
30.
Fagard RH, Celis H, Thijs L, et al. Daytime and nighttime blood pressure as predictors of death and cause-specific cardiovascular events in hypertension. Hypertension. 2008;51(1):55–61.CrossRefPubMed
31.
Bliziotis IA, Destounis A, Stergiou GS. Home versus ambulatory and office blood pressure in predicting target organ damage in hypertension: a systematic review and meta-analysis. J Hypertens. 2012;30(7):1289–99.CrossRefPubMed
32.
Stergiou G, Siontis KC, Ioannidis JP. Home blood pressure as a cardiovascular outcome predictor: it’s time to take this method seriously. Hypertension. 2010;55(6):1301–3.CrossRefPubMed
33.
Fagard RH, Van Den Broeke C, De Cort P. Prognostic significance of blood pressure measured in the office, at home and during ambulatory monitoring in older patients in general practice. J Hum Hypertens. 2005;19(10):801–7.CrossRefPubMed
34.
Mancia G, Facchetti R, Bombelli M, et al. Long-term risk of mortality associated with selective and combined elevation in office, home, and ambulatory blood pressure. Hypertension. 2006;47(5):846–53.CrossRefPubMed
35.
Kobalava ZD, Kotovskaya IV, Lukyanova EA, On behalf of the participants in the program KONSTANTA. Combination therapy of hypertension with the fixed combination of perindopril arginine/amlodipine in clinical practice: the organization and the main results of the study. Kardiologija. 2013;53(6):25–34.
36.
Schillaci G, Pucci G, Parati G. Blood pressure variability. An additional target for antihypertensive treatment. Hypertension. 2011;58:133–5.CrossRefPubMed
37.
Poulter NR. Blood pressure variability: a new challenge in blood pressure measurement. In: Bakris GL, Bertrand M, Blacher J, et al., editors. Improving management of hypertension: reconsidering efficacy assessment. Berlin: Springer Science; 2012. p. 35–46.
38.
Mancia G. Short- and long-term blood pressure variability. Present and future. Hypertension. 2012;60(2):512–7.CrossRefPubMed
39.
Parati G, Bilo G. Calcium antagonist added to angiotensin receptor blocker: a recipe for reducing blood pressure variability? Evidence from day-to-day home blood pressure monitoring. Hypertension. 2012;59:1091–3.CrossRefPubMed
40.
Muntner P, Schimbo D, Tonelli M, Reynolds K, Arnett DK, Oparil S. The relationship between visit-to-visit variability in systolic blood pressure and all-cause mortality in the general population: findings from NHANES III, 1988 to 1994. Hypertension. 2011;57:160–6.CrossRefPubMed
41.
Matsui Y, O’Rourke MF, Hoshide S, et al. Combined effect of angiotensin II receptor blocker and either a calcium channel blocker or diuretic on day-by-day variability of home blood pressure. Hypertension. 2012;59:1132–8.CrossRefPubMed
42.
Matsumoto A, Satoh M, Kikuya M, et al. Day-to-day variability of blood pressure is associated with cognitive decline. The Ohasama study. Hypertension. 2014;63(6):1333–8.CrossRefPubMed
43.
Parati G, Ochoa J, Lombardi C, Bilo G. Assessment and management of blood-pressure variability. Nat Rev Cardiol. 2013;10:143–55.CrossRefPubMed
44.
Parati G, Omboni S, Rizzoni D, et al. Smoothness index: a new, reproducible and clinically relevant measure of the homogeneity of the blood pressure reduction with treatment for hypertension. J Hypertens. 1998;16:1685–91.CrossRefPubMed
Metadaten
Titel
Effectiveness of Fixed-Dose Perindopril/Amlodipine on Clinic, Ambulatory and Self-Monitored Blood Pressure and Blood Pressure Variability: An Open-Label, Non Comparative Study in the General Practice
verfasst von
Yuri A. Karpov
Vladimir M. Gorbunov
Alexander D. Deev
Publikationsdatum
01.12.2015
Verlag
Springer International Publishing
Erschienen in
High Blood Pressure & Cardiovascular Prevention / Ausgabe 4/2015
Print ISSN: 1120-9879
Elektronische ISSN: 1179-1985
DOI
https://doi.org/10.1007/s40292-015-0117-0

Weitere Artikel der Ausgabe 4/2015

High Blood Pressure & Cardiovascular Prevention 4/2015 Zur Ausgabe

Case Report

Safety and Clinical Outcome of the Delivery of Radiofrequency Nerve Ablation Therapy in a Renal Artery of Unusual Anatomy

Review Article

Hypertension in Young People: Epidemiology, Diagnostic Assessment and Therapeutic Approach

Erratum

Erratum to: National Survey on Excellence Centers and Reference Centers for Hypertension Diagnosis and Treatment: Geographical Distribution, Medical Facilities and Diagnostic Opportunities

Commentary

Use of Fixed Combination Therapies to Improve Blood Pressure Control in the Clinical Management of Hypertension: A Key Opportunity

Original Article

Effects of Renal Sympathetic Denervation on Arterial Stiffness and Blood Pressure Control in Resistant Hypertensive Patients: A Single Centre Prospective Study

Review Article

Structural and Functional Abnormalities of Carotid Artery and Their Relation with EVA Phenomenon

Neu im Fachgebiet Kardiologie

„Übersichtlicher Wegweiser“: Lauterbachs umstrittener Klinik-Atlas ist online

17.05.2024 Klinik aktuell Nachrichten

Sie sei „ethisch geboten“, meint Gesundheitsminister Karl Lauterbach: mehr Transparenz über die Qualität von Klinikbehandlungen. Um sie abzubilden, lässt er gegen den Widerstand vieler Länder einen virtuellen Klinik-Atlas freischalten.

„Jeder Fall von plötzlichem Tod muss obduziert werden!“

17.05.2024 Plötzlicher Herztod Nachrichten

Ein signifikanter Anteil der Fälle von plötzlichem Herztod ist genetisch bedingt. Um ihre Verwandten vor diesem Schicksal zu bewahren, sollten jüngere Personen, die plötzlich unerwartet versterben, ausnahmslos einer Autopsie unterzogen werden.

Hirnblutung unter DOAK und VKA ähnlich bedrohlich

17.05.2024 Direkte orale Antikoagulanzien Nachrichten

Kommt es zu einer nichttraumatischen Hirnblutung, spielt es keine große Rolle, ob die Betroffenen zuvor direkt wirksame orale Antikoagulanzien oder Marcumar bekommen haben: Die Prognose ist ähnlich schlecht.

Schlechtere Vorhofflimmern-Prognose bei kleinem linken Ventrikel

17.05.2024 Vorhofflimmern Nachrichten

Nicht nur ein vergrößerter, sondern auch ein kleiner linker Ventrikel ist bei Vorhofflimmern mit einer erhöhten Komplikationsrate assoziiert. Der Zusammenhang besteht nach Daten aus China unabhängig von anderen Risikofaktoren.

Update Kardiologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen
Bildnachweise