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CONFIDENCE II、PROTECT I、SHAKE THE HABIT I 和 SHAKE THE HABIT II 观察性研究中合并使用培哚普利和阿托伐他汀治疗轻中度高血压患者的事后分析。

Post Hoc Analysis of the CONFIDENCE II, PROTECT I, SHAKE THE HABIT I and SHAKE THE HABIT II Observational Studies in Mild to Moderate Hypertensive Patients Treated with Perindopril and Atorvastatin Concomitantly.

机构信息

JSS Medical Research, 9400 boul. Henri-Bourassa Ouest, St-Laurent, QC, H4S 1N8, Canada.

McGill University, Montreal, QC, Canada.

出版信息

Drugs R D. 2018 Dec;18(4):283-293. doi: 10.1007/s40268-018-0255-7.

Abstract

BACKGROUND AND OBJECTIVES

Management of hypertension and dyslipidemia is important when considering cardiovascular disease risk; however, achievement of optimal lipid and blood pressure (BP) targets in clinical practice remains inadequate. This analysis sought to estimate the frequency, effectiveness, and safety of co-administrated atorvastatin and perindopril in routine care.

METHODS

We conducted a post hoc analysis of four Canadian, prospective, multi-center, observational studies assessing real-life effectiveness and safety of perindopril + atorvastatin in mild-to-moderate hypertensive patients with concomitant dyslipidemia over 16 weeks. The safety population comprised patients receiving one or more doses of free combination perindopril + atorvastatin; the full analysis set (FAS) received perindopril + atorvastatin at baseline, with one or more post-baseline systolic BP measurements while on treatment.

RESULTS

A total of 3541 and 3172 patients were included in the safety population and FAS, respectively. At the last observation carried forward, significant reductions in mean systolic BP (- 18.0 mmHg; p < 0.001) and diastolic BP (- 8.9 mmHg; p < 0.001) were observed; target BP was achieved by 73.1% of patients. Emergent adverse events (AEs) were reported in 8.0% of patients, the most common being cough (4.5% of patients), headache (0.9%), and dizziness (0.8%). Four serious AEs were reported among three (0.1%) patients. No differences were observed in effectiveness or safety between studies.

CONCLUSIONS

Concomitant perindopril + atorvastatin therapy demonstrated similar efficacy across all studies, with significant reductions in BP and achievement of target BP levels observed in a real-world setting. Results align with known safety profiles of atorvastatin and perindopril, with no unexpected AEs observed when compared with data from treatment with the individual drugs.

摘要

背景和目的

在考虑心血管疾病风险时,高血压和血脂异常的管理很重要;然而,在临床实践中,达到最佳的血脂和血压(BP)目标仍然不足。本分析旨在评估阿托伐他汀与培哚普利联合治疗在常规护理中的频率、有效性和安全性。

方法

我们对四项加拿大前瞻性多中心观察性研究进行了事后分析,评估了培哚普利+阿托伐他汀在 16 周内对伴有血脂异常的轻中度高血压患者的真实疗效和安全性。安全性人群包括接受一种或多种剂量的培哚普利+阿托伐他汀自由联合治疗的患者;全分析集(FAS)患者在基线时接受培哚普利+阿托伐他汀治疗,并在治疗期间进行了一次或多次基线后收缩压测量。

结果

安全性人群和 FAS 分别纳入 3541 例和 3172 例患者。在最后一次观察推进时,平均收缩压(-18.0mmHg;p<0.001)和舒张压(-8.9mmHg;p<0.001)显著降低;73.1%的患者达到了目标血压。8.0%的患者报告了新发不良事件(AE),最常见的是咳嗽(4.5%的患者)、头痛(0.9%)和头晕(0.8%)。三名(0.1%)患者报告了四起严重不良事件。四项研究在疗效和安全性方面无差异。

结论

培哚普利+阿托伐他汀联合治疗在所有研究中均显示出相似的疗效,在真实环境中观察到血压显著降低和目标血压水平的达到。结果与阿托伐他汀和培哚普利已知的安全性特征一致,与单独使用这些药物的数据相比,未观察到意外的 AE。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/08ab/6277322/a7f6034d76d3/40268_2018_255_Fig1_HTML.jpg

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