Patient adherence and preference considerations in managing cardiovascular risk: focus on single pill and amlodipine/atorvastatin fixed combination

Figures & data

Table 1 Determinants of non-adherence and poor persistence

1. Patient characteristics:

Female

Age under 45 years

Age over 75 years

Low socio-economic status

Non-White

Comorbidity: dementia, depression, myocardial infarction after statin or antihypertensive use

Asymptomatic/feeling in good health

2. Regimen characteristics

Multiple daily dosing

Multiple drug regimens

3. System characteristics

Long waiting time

Lack of insurance

Medication cost

Table 2 Advantage of fixed-dose combination therapy

Increased compliance, simplified titration and convenience of use

Additive or synergistic effects

Enhancing effects in specific populations

Attenuation in adverse events

Improved overall results

Greater response

Lower cost

Availability in a variety of dosing combinations, making it easy to escalate dose of one medicine while keeping same dose for other medicine (Caduet)

Table 3 Results of trials of amlodipine and atorvastatin combination

Study	No of patients	Baseline value SPB/DBP (mmHg)	Baseline value LDL-C (mg/dL)	Patients achieving BP and LDL-C goals (%)	Patients achieving BP goals (%)	Patients achieving LDL-C goals (%)
CAPABLE	499	147/91	142.2	48.3	56.8	73.7
GEMINI	1220	146/88	153	57.7	65.5	74.7
GEMINI-AALA	1649	146/88	131.3	55.2	61.3	87.1
JEWEL I	1138	152/90	193	62.9	66.8	90.7
JEWEL II	1107	152/90	193	50.6	65.7	73.1

Abbreviations: SBP, systolic blood pressure; DBP, diastolic blood pressure; LDL-C, low density lipoprotein cholesterol.