Impact of Statin Therapy on the Blood Pressure-Lowering Efficacy of a Single-Pill Perindopril/Amlodipine Combination in
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ORIGINAL ARTICLE
Impact of Statin Therapy on the Blood Pressure-Lowering Efficacy of a Single-Pill Perindopril/Amlodipine Combination in Hypertensive Patients with Hypercholesterolemia Yuriy Sirenko1 • Ganna Radchenko1 • On behalf of the PERSPECTIVA Study Group
Received: 24 October 2016 / Accepted: 20 January 2017 Ó Springer International Publishing Switzerland 2017
Abstract Introduction Several lines of research indicate that statins can lower blood pressure (BP) independently of their lipidlowering effects when used as monotherapy and in combination with antihypertensive agents. Aim This short-term, open-label study examined whether statin therapy had a synergistic effect on the BP-lowering efficacy of perindopril/amlodipine in a subgroup of patients in the PERSPECTIVA study with concomitant hypertension and hypercholesterolemia, with or without statin at baseline. Methods The PERSPECTIVA study recruited 732 adults with untreated or uncontrolled hypertension. This subgroup analysis of PERSPECTIVA included 587 patients with concomitant hypertension and hypercholesterolemia (mean age 56.7 years) of whom 226 were receiving a statin at baseline (statin [?] group) and 361 were not (statin [-] group). All patients received treatment with single-pill combination perindopril/amlodipine at a dose of 5/5, 10/5 or 10/10 mg/day. The study duration was 60 days with followup visits for BP monitoring at 7, 15, 30 and 60 days. Results At day 60, BP control (\140/90 mmHg) was significantly greater in the statin [?] vs statin [-] group: 73 vs 64% respectively (?14%, P \ 0.05). In the statin [?] group, the single-pill perindopril/amlodipine combination significantly reduced BP in patients previously untreated (n = 18), or treated with monotherapy (n = 97), dual therapy (n = 93), or triple therapy (n = 18): -38.8/-20.0, -39.1/20.1, -38.0/-19.4, -39.9/-18.3 mmHg respectively
& Yuriy Sirenko [email protected] 1
National Scientific Center, Strazhesko Institute of Cardiology, 5, Narodnogo Opolcheniya Street, Kiev 03680, Ukraine
(P \ 0.001 vs baseline BP). The greatest BP reductions were observed in the first 7 days. Treatment was well tolerated with a similar rate of adverse events in the statin [?] group (0.9%) vs the statin [-] group (2.5%). Conclusion BP control rates in patients with uncontrolled hypertension and concomitant hypercholesterolemia are significantly improved with a treatment regimen that combines perindopril/amlodipine with statin therapy, regardless of previous antihypertensive therapy. This subanalysis of the PERSPECTIVA study supports the synergistic BP-lowering effect of statins and perindopril/amlodipine. Keywords Adherence Perindopril Amlodipine Singlepill combination Fixed-dose combination Hypertension Hypercholesterolemia Statin
1 Introduction Hypertension and hypercholesterolemia/dyslipidemia are common, modifiable risk factors for cardiovascular disease (CVD) that frequently coexist [1–3]. Examination of data from the National Health and Nutrition Examination Surveys (NHANES) 1988–1994,
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