Effectiveness of perindopril/amlodipine fixed dose combination in everyday clinical practice: results from the EMERALD study

Abstract

Objective: The rates of blood pressure (BP) control worldwide are discouraging. This study had the purpose of assessing the effectiveness of perindopril/amlodipine fixed dose combination on BP-lowering efficacy, and recording adherence, safety and tolerability during a 4 month treatment period.

Research design and methods: In this multicenter, observational study 2269 hypertensive patients were prospectively enrolled. The data were recorded at 1 and 4 months of treatment.

Main outcome measures and results: Between the first and third visits mean BP values (systolic/diastolic) decreased from 158.4 ± 13.6/89.9 ± 8.7 mmHg to 130.0 ± 7.9/77.7 ± 6.3 mmHg (P < 0.001). The magnitude of BP reduction depended on baseline blood pressure levels and total cardiovascular (CV) risk (P < 0.001). Patients with grade 1, 2 and 3 showed a BP reduction of 21.9/10.0 mmHg, 34.4/14.2 mmHg and 51.4/21.2 mmHg, accordingly (P < 0.001). Patients with very high, high, moderate and low added CV risk showed a BP reduction of 35.7/14.9 mmHg, 27.5/12.1 mmHg, 28.6/12.2 mmHg and 14.5/5.8 mmHg respectively (P < 0.001). Adherence to treatment was high: 98.3% of the sample was taking the treatment “every day” or “quite often”, while only 15 patients (0.7% of the sample) prematurely discontinued treatment. Study interpretation may be limited by the fact that this is an observational study with no comparator and a short follow-up period.

Conclusions: A perindopril/amlodipine fixed dose combination significantly decreases BP levels. The degree of BP reduction is related to baseline BP levels and total CV risk.

Keywords:

• Adherence
• Amlodipine
• Fixed-dose combination
• Hypertension
• Perindopril

Transparency

Declaration of funding

This study was funded by Servier Hellas.

Acknowledgements

We would like to thank all the Investigators of the "Effectiveness of perindopril/amlodipine fixed dose combination in everyday clinical practice: results from the EMERALD study".

Declaration of financial/other relationships

C.V. has disclosed that he has received honoraria for lecturing and a research grant from Servier Hellas. Α.K. has disclosed that he has received a research grant from Servier Hellas. V.G. has disclosed that she was formerly employed by Servier Hellas and is currently employed by MSD Greece. M.K. has disclosed that he was formerly employed by the medical department of Servier Hellas.

CMRO peer reviewers on this manuscript have no relevant financial or other relationships to disclose.