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[PP.12.11] EFFICACY AND SAFETY OF SINGLE-PILL COMBINATION PERINDOPRIL/AMLODIPINE IN PATIENTS WITH UNCONTROLLED HYPERTENSION ON PREVIOUS ANGIOTENSIN RECEPTOR BLOCKER-BASED TREATMENT

Objective: Arterial hypertension is one of the major independent risk factors for stroke and coronary artery disease, as well as for cardiovascular complications, including myocardial infarction and heart failure. However, the adequate control of blood pressure (BP) remains a critical issue in the treatment of hypertensive patients in spite of a wide range of available treatments. The objective of this study was to evaluate the BP-lowering efficacy and tolerability of a single-pill combination (SPC) of perindopril arginine/amlodipine (P/A) in patients with arterial hypertension uncontrolled with previous angiotensin receptor blocker (ARB) based treatment. Design and method: This subanalysis of PREVOSKHODSTVO (SUPERIORITY), an open-label, observational, multicenter study (n = 1014), included 125 Russian hypertensive patients (70.4% women, mean 57.2 ± 10.0 years) with uncontrolled BP (systolic 140–179 mmHg, diastolic 90–109 mmHg) on previous treatment with ARBs as a single agent (37.6%, 74.5% of which were treated with losartan) or as a component of a two-drug combination mainly with diuretics, beta-blockers or calcium-channel blockers: SPC (22.4%) and free-combination (40%). Patients were switched to SPC P/A at a dose determined by the physician. Office systolic and diastolic BP, and BP control rate (BP<140/90 mm Hg) were assessed at baseline and weeks 2, 4, 12 and 24. Results: Baseline BP was 159.9 ± 8.8/93.8 ± 6.8 mmHg. Switching to SPC P/A from previous ARB-based treatment lead to a significant (P < 0.001) decrease of systolic/diastolic BP: 143.9 ± 10.7/86.4 ± 6.5 mmHg at week 2; 134.0 ± 11.9/81.8 ± 6.6 at week 4; 129.3 ± 8.3/80.1 ± 5.6 at week 12; 125.1 ± 7.1/78.1 ± 4.7 mmHg at week 24. The number of patients who reached target BP was 24%, 61%, 75%, and 97%, accordingly, at 2, 4, 12, and 24 weeks. Treatment with SPC P/A was well tolerated. None of the patients reported any orthostatic hypotension, cough, or peripheral edema and none were excluded due to side effects. Conclusions: In patients with uncontrolled hypertension on previous ARB-based treatment who were switched to SPC P/A, BP was effectively reduced and controlled in 97% of patients at 24 weeks, with a good tolerability and safety profile.