Optimization of blood pressure treatment with fixed-combination perindopril/amlodipine in patients with arterial hypertension

Background: Fixed-dose combination treatments using an angiotensin-converting enzyme (ACE) inhibitor, such as perindopril, plus a calcium channel blocker (CCB), such as amlodipine, have been endorsed by guidelines because they improve blood pressure control and cardiovascular outcomes in hypertensive patients, while being well tolerated and well adhered to by patients. Objective: This study aimed to assess the blood pressure-lowering effects of fixed-combination perindopril/amlodipine in patients previously treated with an ACE inhibitor and/or a CCB. Methods: This was a prospective, real-life, open-label, longitudinal, phase IV study conducted in 223 outpatient medical centres across Slovakia. 2132 previously treated patients whose hypertension was insufficiently controlled at baseline or who tolerated treatment poorly were included. Patients were treated for 3 months with fixed-combination perindopril/amlodipine 5?mg/5?mg, 5?mg/10?mg, 10?mg/5?mg and 10?mg/10?mg. The main outcome measure was a reduction in mean systolic blood pressure (SBP) and diastolic blood pressure (DBP) and achievement of blood pressure targets (SBP/DBP <140/90?mmHg or <130/80?mmHg for patients with type 2 diabetes mellitus or high cardiovascular risk). Results: After 3 months of treatment, mean?±?SD SBP/DBP had decreased from 158.5?±?17.5/93.6?±?9.8?mmHg to 132.9?±?10.6/80.7?±?6.2?mmHg (p?