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@article{Poulter:2019:10.1007/s40256-018-00314-4,
author = {Poulter, NR and Dolan, E and Gupta, AK and O'Brien, E and Whitehouse, A and Sever, PS},
doi = {10.1007/s40256-018-00314-4},
journal = {American Journal of Cardiovascular Drugs},
pages = {313--323},
title = {Efficacy and safety of incremental dosing of a new single-pill formulation of perindopril and amlodipine in the management of hypertension},
url = {http://dx.doi.org/10.1007/s40256-018-00314-4},
volume = {19},
year = {2019}
}

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TY  - JOUR
AB  - BACKGROUND: Angiotensin-converting enzyme inhibitors and calcium channel blockers in combination are widely recommended in hypertension guidelines. The advantages of single-pill combinations (SPCs) are increasingly recognized, so a dosage-adapted combination of perindopril and amlodipine was developed for the initial management of hypertension. OBJECTIVE: This randomized trial evaluated the blood pressure (BP)-lowering efficacy of four incremental doses of perindopril/amlodipine SPC in adults with mild-to-severe hypertension. METHODS: Eligible patients (N = 1617) were randomized to SPC perindopril 3.5 mg/amlodipine 2.5 mg (i.e., 3.5/2.5 mg) daily, uptitrating as required on a monthly basis up to 14/10 mg until BP < 140/90 mmHg (< 130/80 mmHg in patients with diabetes). The primary endpoint (proportion with controlled BP at each uptitrated dose) was evaluated at 6 months, and safety was evaluated at 9 months; 24-h ambulatory BP measurement and BP variability were also investigated. Control-arm participants (n = 1653) were randomized to irbesartan 150 mg daily, uptitrating over 3 months to irbesartan/hydrochlorothiazide 300/25 mg. RESULTS: Significant increases in BP control were observed with each dosage increment of perindopril/amlodipine, which was well tolerated, rising from 21% (3.5/2.5 mg) to 30% (7/5 mg), 37% (14/5 mg), and 42% (14/10 mg) after 1, 2, 3, and 6 months, respectively. Reductions in mean systolic and diastolic BP occurred with each incremental dose of perindopril/amlodipine. After 6 months, mean BP had fallen by 24.8/10.8 mmHg. Irbesartan-based therapy reduced clinic and 24-h BP similarly to perindopril/amlodipine, but perindopril/amlodipine reduced BP variability more in comparison. CONCLUSIONS: Incremental uptitration with dosage-adapted perindopril/amlodipine SPC is a safe and effective strategy for mana
AU  - Poulter,NR
AU  - Dolan,E
AU  - Gupta,AK
AU  - O'Brien,E
AU  - Whitehouse,A
AU  - Sever,PS
DO  - 10.1007/s40256-018-00314-4
EP  - 323
PY  - 2019///
SN  - 1175-3277
SP  - 313
TI  - Efficacy and safety of incremental dosing of a new single-pill formulation of perindopril and amlodipine in the management of hypertension
T2  - American Journal of Cardiovascular Drugs
UR  - http://dx.doi.org/10.1007/s40256-018-00314-4
UR  - https://www.ncbi.nlm.nih.gov/pubmed/30919249
UR  - http://hdl.handle.net/10044/1/70991
VL  - 19
ER  -

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