Bansal Sandeep, Chauhan D K, Ramesh D, Barmare Shahid, Chakraborty Shaibal
Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi 110029, India.
4718/21, Dayanand Road Ansari Road, Daryaganj, New Delhi 110002, India.
Indian Heart J. 2014 Nov-Dec;66(6):635-9. doi: 10.1016/j.ihj.2014.10.419. Epub 2014 Nov 28.
Recent hypertension guidelines recommend initiation of treatment with a fixed dose combination of two drugs for more effective and quicker blood pressure control. Few of these have been assessed for efficacy and acceptability. This study examines the short term blood pressure control and acceptability of perindopril, with or without its fixed dose combinations (FDC) with amlodipine and Indapamide in younger patients.
In a multicentre prospective observational study, patients with stage 1 hypertension were prescribed perindopril 4 mg per day. Those with stage 2 or 3 hypertension were prescribed a single tablet per day of 4 mg perindopril and 5 mg amlodipine (COVERSYL AM), or 4 mg perindopril and 1.25 mg indapamide (COVERSYL PLUS)for 45 days. The primary outcomes were the frequency of patients achieving blood pressure control and the adverse effect of pedal edema.
Of 426 patients, with a mean age of 45 years, distributed throughout India, and an average (SD) baseline systolic/diastolic blood pressure of 157.2 (13.5)/98.6 (7.4), 303 (71.1%) achieved blood pressure control. Mean (SD) SBP/DBP decreased from baseline by 26.9 (12.6), and DBP by 15.4 (7.2) mm Hg. Few patients discontinued treatment, and the frequency of cough that interfered with sleep and ankle edema was low.
In patients requiring combination antihypertensive treatment, the regimen of perindopril alone or its FDC with Indapamide or amlodipine reduces blood pressure effectively, resulting in high rates of blood pressure control over the short term, with a low frequency of side effects including cough and pedal edema.
近期高血压指南推荐使用两种药物的固定剂量组合开始治疗,以更有效、更快地控制血压。其中很少有药物经过疗效和可接受性评估。本研究考察培哚普利单用或与氨氯地平及吲达帕胺的固定剂量组合(FDC)在年轻患者中的短期血压控制情况及可接受性。
在一项多中心前瞻性观察研究中,为1级高血压患者每日开具4毫克培哚普利。为2级或3级高血压患者每日开具一片4毫克培哚普利与5毫克氨氯地平的复方制剂(雅施达氨氯地平),或4毫克培哚普利与1.25毫克吲达帕胺的复方制剂(雅施达复方),治疗45天。主要结局为血压得到控制的患者频率及足部水肿的不良反应。
426例患者平均年龄45岁,分布于印度各地,平均(标准差)基线收缩压/舒张压为157.2(13.5)/98.6(7.4),其中303例(71.1%)血压得到控制。平均(标准差)收缩压/舒张压较基线分别降低26.9(12.6)和15.4(7.2)毫米汞柱。很少有患者停药,干扰睡眠的咳嗽及踝部水肿的发生率较低。
在需要联合降压治疗的患者中,单用培哚普利或其与吲达帕胺或氨氯地平的固定剂量组合方案能有效降低血压,短期内血压控制率高,包括咳嗽和足部水肿在内的副作用发生率低。