Skip to main content
Erschienen in: Clinical Drug Investigation 4/2019

01.04.2019 | Original Research Article

Effectiveness and Adherence to Treatment with Perindopril/Indapamide/Amlodipine Single-Pill Combination in a Greek Population with Hypertension

verfasst von: Kostas Tsioufis, Stella Douma, Manolis S. Kallistratos, Athanasios J. Manolis

Erschienen in: Clinical Drug Investigation | Ausgabe 4/2019

Einloggen, um Zugang zu erhalten

Abstract

Background

Despite the overwhelming evidence and the established benefits of antihypertensive treatment, adherence to treatment remains low.

Objective

To assess the adherence to treatment with a perindopril/indapamide/amlodipine single-pill combination (SPC), its effectiveness on blood pressure (BP) reduction, as well as the safety and tolerability of this SPC over a 4-month treatment period.

Methods

This multicenter, non-interventional study prospectively included 2285 hypertensive patients on perindopril/indapamide/amlodipine SPC. The data were recorded at baseline, 1 month, and 4 months.

Results

Of the 2285 hypertensive patients included in the study, 50.5% were at “high/very high risk”. Mean systolic (SBP)/diastolic (DBP) decreased from 162.3 ± 13.3/93.1 ± 9.3 mmHg at baseline to 129.7 ± 8.3/78.6 ± 7.1 mmHg at 4 months (p < 0.001). Patients with higher baseline BP levels showed greater BP reduction. Patients with hypertension stages 1, 2, and 3 showed mean SBP/DBP reductions of 21.5/10.4 mmHg, 34.2/14.7 mmHg, and 51.2/22.5 mmHg, respectively, at study end (p < 0.001). Only 26 patients (1.1%) prematurely discontinued treatment (0.58% due to an adverse reaction or event).

Conclusions

Perindopril/indapamide/amlodipine SPC decreased BP levels rapidly and significantly. The degree of BP reduction was associated with the severity of hypertension and/or with total cardiovascular risk at baseline. Simplifying the drug regimen by using this SPC improved adherence and showed excellent tolerability.
Literatur
1.
Zurück zum Zitat Poulter NR, Prabhakaran D, Caulfield M. Hypertension. Lancet. 2015;22(386):801–12.CrossRef Poulter NR, Prabhakaran D, Caulfield M. Hypertension. Lancet. 2015;22(386):801–12.CrossRef
3.
Zurück zum Zitat Yoon SS, Carroll MD, Fryar CD. Hypertension prevalence and control among adults: United States, 2011–2014. NCHS Data Brief. 2015;220:1–8. Yoon SS, Carroll MD, Fryar CD. Hypertension prevalence and control among adults: United States, 2011–2014. NCHS Data Brief. 2015;220:1–8.
4.
Zurück zum Zitat Okonofua EC, Simpson KN, Jesri A, Rehman SU, Durkalski VL, Egan BM. Therapeutic inertia is an impediment to achieving the Healthy People 2010 blood pressure control goals. Hypertension. 2006;47:345–51.CrossRefPubMed Okonofua EC, Simpson KN, Jesri A, Rehman SU, Durkalski VL, Egan BM. Therapeutic inertia is an impediment to achieving the Healthy People 2010 blood pressure control goals. Hypertension. 2006;47:345–51.CrossRefPubMed
5.
Zurück zum Zitat Márquez PHP, Torres OH, San-José A, Vidal X, Agustí A, Formiga F, et al. Potentially inappropriate antihypertensive prescriptions to elderly patients: results of a prospective, observational study. Drugs Aging. 2017;34:453–66.CrossRefPubMed Márquez PHP, Torres OH, San-José A, Vidal X, Agustí A, Formiga F, et al. Potentially inappropriate antihypertensive prescriptions to elderly patients: results of a prospective, observational study. Drugs Aging. 2017;34:453–66.CrossRefPubMed
6.
Zurück zum Zitat Petrák O, Zelinka T, Štrauch B, Rosa J, Šomlóová Z, Indra T, Combination antihypertensive therapy in clinical practice, et al. The analysis of 1254 consecutive patients with uncontrolled hypertension. J Hum Hypertens. 2016;30:35–9.CrossRefPubMed Petrák O, Zelinka T, Štrauch B, Rosa J, Šomlóová Z, Indra T, Combination antihypertensive therapy in clinical practice, et al. The analysis of 1254 consecutive patients with uncontrolled hypertension. J Hum Hypertens. 2016;30:35–9.CrossRefPubMed
7.
Zurück zum Zitat Al-Ganmi AH, Perry L, Gholizadeh L, Alotaibi AM. Cardiovascular medication adherence among patients with cardiac disease: a systematic review. J Adv Nurs. 2016;72:3001–14.CrossRefPubMed Al-Ganmi AH, Perry L, Gholizadeh L, Alotaibi AM. Cardiovascular medication adherence among patients with cardiac disease: a systematic review. J Adv Nurs. 2016;72:3001–14.CrossRefPubMed
8.
Zurück zum Zitat Frank J. Managing hypertension using combination therapy. Am Fam Physician. 2008;77:1279–86.PubMed Frank J. Managing hypertension using combination therapy. Am Fam Physician. 2008;77:1279–86.PubMed
9.
Zurück zum Zitat Thoenes M, Neuberger HR, Volpe M, Khan BV, Kirch W, Böhm M. Antihypertensive drug therapy and blood pressure control in men and women: an international perspective. J Hum Hypertens. 2010;24:336–44.CrossRefPubMed Thoenes M, Neuberger HR, Volpe M, Khan BV, Kirch W, Böhm M. Antihypertensive drug therapy and blood pressure control in men and women: an international perspective. J Hum Hypertens. 2010;24:336–44.CrossRefPubMed
10.
Zurück zum Zitat Cushman W, Ford C, Cutler J, Margolis K, Davis B, Grimm R, et al. Success and predictors of blood pressure control in diverse North American settings: the antihypertensive and lipid-lowering treatment to prevent heart attack trial (ALLHAT). J Clin Hypertens (Greenwich). 2002;4:393–404.CrossRef Cushman W, Ford C, Cutler J, Margolis K, Davis B, Grimm R, et al. Success and predictors of blood pressure control in diverse North American settings: the antihypertensive and lipid-lowering treatment to prevent heart attack trial (ALLHAT). J Clin Hypertens (Greenwich). 2002;4:393–404.CrossRef
11.
Zurück zum Zitat Mancia G, Fagard R, Narkiewicz K, Redon J, Zanchetti A, Böhm M, et al. 2013 ESH/ESC Guidelines for the management of arterial hypertension: the Task Force for the management of arterial hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). Eur Heart J. 2013;34:2159–219.CrossRefPubMed Mancia G, Fagard R, Narkiewicz K, Redon J, Zanchetti A, Böhm M, et al. 2013 ESH/ESC Guidelines for the management of arterial hypertension: the Task Force for the management of arterial hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). Eur Heart J. 2013;34:2159–219.CrossRefPubMed
12.
Zurück zum Zitat Mancia G, Rea F, Cuspidi C, Grassi G, Corrao G. Blood pressure control in hypertension. Pros and cons of available treatment strategies. J Hypertens. 2017;35:225–33.CrossRefPubMed Mancia G, Rea F, Cuspidi C, Grassi G, Corrao G. Blood pressure control in hypertension. Pros and cons of available treatment strategies. J Hypertens. 2017;35:225–33.CrossRefPubMed
14.
Zurück zum Zitat Mourad JJ, Amodeo C, de Champvallins M, Brzozowska-Villatte R, Asmar R, Study coordinators, investigators. Blood pressure-lowering efficacy and safety of perindopril/indapamide/amlodipine single-pill combination in patients with uncontrolled essential hypertension: a multicenter, randomized, double-blind, controlled trial. J Hypertens. 2017;35(7):1481–95. https://doi.org/10.1097/hjh.0000000000001359.CrossRefPubMed Mourad JJ, Amodeo C, de Champvallins M, Brzozowska-Villatte R, Asmar R, Study coordinators, investigators. Blood pressure-lowering efficacy and safety of perindopril/indapamide/amlodipine single-pill combination in patients with uncontrolled essential hypertension: a multicenter, randomized, double-blind, controlled trial. J Hypertens. 2017;35(7):1481–95. https://​doi.​org/​10.​1097/​hjh.​0000000000001359​.CrossRefPubMed
15.
Zurück zum Zitat Yang W, Chang J, Kahler KH, Fellers T, Orloff J, Wu EQ, et al. Evaluation of compliance and health care utilization in patients treated with single pill vs. free combination antihypertensives. Curr Med Res Opin. 2010;26:2065–76.CrossRefPubMed Yang W, Chang J, Kahler KH, Fellers T, Orloff J, Wu EQ, et al. Evaluation of compliance and health care utilization in patients treated with single pill vs. free combination antihypertensives. Curr Med Res Opin. 2010;26:2065–76.CrossRefPubMed
16.
Zurück zum Zitat Bangalore S, Kamalakkannan G, Parkar S, Messerli F. Fixed-dose combinations improve medication compliance: a meta-analysis. Am J Med. 2007;120:713–9.CrossRefPubMed Bangalore S, Kamalakkannan G, Parkar S, Messerli F. Fixed-dose combinations improve medication compliance: a meta-analysis. Am J Med. 2007;120:713–9.CrossRefPubMed
17.
Zurück zum Zitat Brixner D, Jackson K, Sheng X, Nelson R, Keskinaslan A. Assessment of adherence, persistence, and costs among valsartan and hydrochlorothiazide retrospective cohorts in free- and fixed-dose combinations. Curr Med Res Opin. 2008;24:2597–607.CrossRefPubMed Brixner D, Jackson K, Sheng X, Nelson R, Keskinaslan A. Assessment of adherence, persistence, and costs among valsartan and hydrochlorothiazide retrospective cohorts in free- and fixed-dose combinations. Curr Med Res Opin. 2008;24:2597–607.CrossRefPubMed
18.
Zurück zum Zitat Gupta A, Arshad S, Poulter N. Compliance, safety, and effectiveness of fixed-dose combinations of antihypertensive agents: a metaanalysis. Hypertension. 2010;55:399–407.CrossRefPubMed Gupta A, Arshad S, Poulter N. Compliance, safety, and effectiveness of fixed-dose combinations of antihypertensive agents: a metaanalysis. Hypertension. 2010;55:399–407.CrossRefPubMed
19.
Zurück zum Zitat Belsey JD. Optimizing adherence in hypertension: a comparison of outcomes and costs using single tablet regimens vs individual component regimens. J Med Econ. 2012;15:897–905.CrossRefPubMed Belsey JD. Optimizing adherence in hypertension: a comparison of outcomes and costs using single tablet regimens vs individual component regimens. J Med Econ. 2012;15:897–905.CrossRefPubMed
20.
Zurück zum Zitat Vermeire E, Hearnshaw H, Van Royen P, Denekens J. Patient adherence to treatment: three decades of research. A comprehensive review. J Clin Pharm Ther. 2001;26:331–42.CrossRefPubMed Vermeire E, Hearnshaw H, Van Royen P, Denekens J. Patient adherence to treatment: three decades of research. A comprehensive review. J Clin Pharm Ther. 2001;26:331–42.CrossRefPubMed
21.
Zurück zum Zitat Caban-Martinez AJ, Davila EP, Zhao W, Arheart K, Hooper MW, Byrne M, et al. Disparities in hypertension control advice according to smoking status. Prev Med. 2010;51:302–6.CrossRefPubMedPubMedCentral Caban-Martinez AJ, Davila EP, Zhao W, Arheart K, Hooper MW, Byrne M, et al. Disparities in hypertension control advice according to smoking status. Prev Med. 2010;51:302–6.CrossRefPubMedPubMedCentral
23.
Zurück zum Zitat Chung N, Baek S, Chen M-F, Liau CS, Park CG, Park J, et al. 2008 Expert recommendations on the challenges of hypertension in Asia. Int J Clin Pract. 2008;62:1306–12.CrossRefPubMed Chung N, Baek S, Chen M-F, Liau CS, Park CG, Park J, et al. 2008 Expert recommendations on the challenges of hypertension in Asia. Int J Clin Pract. 2008;62:1306–12.CrossRefPubMed
24.
Zurück zum Zitat Corrao G, Parodi A, Nicotra F, Zambon A, Merlino L, Cesana G, et al. Better compliance to antihypertensive medications reduces cardiovascular risk. J Hypertens. 2011;29:610–8.CrossRefPubMed Corrao G, Parodi A, Nicotra F, Zambon A, Merlino L, Cesana G, et al. Better compliance to antihypertensive medications reduces cardiovascular risk. J Hypertens. 2011;29:610–8.CrossRefPubMed
25.
Zurück zum Zitat Gradman AH, Basile JN, Carter BL, Bakris GL. Combination therapy in hypertension. J Clin Hypertens (Greenwich). 2011;13:146–54.CrossRef Gradman AH, Basile JN, Carter BL, Bakris GL. Combination therapy in hypertension. J Clin Hypertens (Greenwich). 2011;13:146–54.CrossRef
26.
Zurück zum Zitat Byrd JB, Zeng C, Tavel HM, Magid DJ, O’Connor PJ, Margolis KL, et al. Combination therapy as initial treatment for newly diagnosed hypertension. Am Heart J. 2011;162:340–6.CrossRefPubMedPubMedCentral Byrd JB, Zeng C, Tavel HM, Magid DJ, O’Connor PJ, Margolis KL, et al. Combination therapy as initial treatment for newly diagnosed hypertension. Am Heart J. 2011;162:340–6.CrossRefPubMedPubMedCentral
27.
Zurück zum Zitat Selak V, Elley CR, Bullen C, Crengle S, Wadham A, Rafter N, et al. Effect of fixed dose combination treatment on adherence and risk factor control among patients at high risk of cardiovascular disease: randomised controlled trial in primary care. BMJ. 2014;27(348):g3318. https://doi.org/10.1136/bmj.g3318.CrossRef Selak V, Elley CR, Bullen C, Crengle S, Wadham A, Rafter N, et al. Effect of fixed dose combination treatment on adherence and risk factor control among patients at high risk of cardiovascular disease: randomised controlled trial in primary care. BMJ. 2014;27(348):g3318. https://​doi.​org/​10.​1136/​bmj.​g3318.CrossRef
28.
Zurück zum Zitat Zanchetti A, Thomopoulos C, Parati G. Randomized controlled trials of blood pressure lowering in hypertension: a critical reappraisal. Circ Res. 2015;13(116):1058–73.CrossRef Zanchetti A, Thomopoulos C, Parati G. Randomized controlled trials of blood pressure lowering in hypertension: a critical reappraisal. Circ Res. 2015;13(116):1058–73.CrossRef
29.
Zurück zum Zitat Makani H, Bangalore S, Romero J, Wever-Pinzon O, Messerli FH. Effect of renin-angiotensin system blockade on calcium channel blocker-associated peripheral edema. Am J Med. 2011;124:128–35.CrossRefPubMed Makani H, Bangalore S, Romero J, Wever-Pinzon O, Messerli FH. Effect of renin-angiotensin system blockade on calcium channel blocker-associated peripheral edema. Am J Med. 2011;124:128–35.CrossRefPubMed
30.
Zurück zum Zitat Hamdidouche I, Jullien V, Boutouyrie P, Billaud E, Azizi M, Laurent S. Drug adherence in hypertension: from methodological issues to cardiovascular outcomes. J Hypertens. 2017;35:1133–44.CrossRefPubMed Hamdidouche I, Jullien V, Boutouyrie P, Billaud E, Azizi M, Laurent S. Drug adherence in hypertension: from methodological issues to cardiovascular outcomes. J Hypertens. 2017;35:1133–44.CrossRefPubMed
31.
Zurück zum Zitat Fogari R, Malamani GD, Zoppi A, Mugellini A, Rinaldi A, Vanasia A, et al. Effect of benazepril addition to amlodipine on ankle oedema and subcutaneous tissue pressure in hypertensive patients. J Hum Hypertens. 2003;17:207–12.CrossRefPubMed Fogari R, Malamani GD, Zoppi A, Mugellini A, Rinaldi A, Vanasia A, et al. Effect of benazepril addition to amlodipine on ankle oedema and subcutaneous tissue pressure in hypertensive patients. J Hum Hypertens. 2003;17:207–12.CrossRefPubMed
33.
Zurück zum Zitat Heidenreich PA, Fonarow GC. Are registry hospitals different? A comparison of patients admitted to hospitals of a commercial heart failure registry with those from national and community cohorts. Am Heart J. 2006;152:935–9.CrossRefPubMed Heidenreich PA, Fonarow GC. Are registry hospitals different? A comparison of patients admitted to hospitals of a commercial heart failure registry with those from national and community cohorts. Am Heart J. 2006;152:935–9.CrossRefPubMed
34.
Zurück zum Zitat Granger CB, Gersh BJ. Clinical trials and registries in cardiovascular disease: competitive or complementary? Eur Heart J. 2010;31:520–1.CrossRefPubMed Granger CB, Gersh BJ. Clinical trials and registries in cardiovascular disease: competitive or complementary? Eur Heart J. 2010;31:520–1.CrossRefPubMed
35.
Zurück zum Zitat Burnier M, Wuerzner G, Struijker-Boudier H, Urquhart J. Measuring, analyzing, and managing drug adherence in resistant hypertension. Hypertension. 2013;62:218–25.CrossRefPubMed Burnier M, Wuerzner G, Struijker-Boudier H, Urquhart J. Measuring, analyzing, and managing drug adherence in resistant hypertension. Hypertension. 2013;62:218–25.CrossRefPubMed
Metadaten
Titel
Effectiveness and Adherence to Treatment with Perindopril/Indapamide/Amlodipine Single-Pill Combination in a Greek Population with Hypertension
verfasst von
Kostas Tsioufis
Stella Douma
Manolis S. Kallistratos
Athanasios J. Manolis
Publikationsdatum
01.04.2019
Verlag
Springer International Publishing
Erschienen in
Clinical Drug Investigation / Ausgabe 4/2019
Print ISSN: 1173-2563
Elektronische ISSN: 1179-1918
DOI
https://doi.org/10.1007/s40261-019-00761-0

Weitere Artikel der Ausgabe 4/2019

Clinical Drug Investigation 4/2019 Zur Ausgabe