Article thumbnail

Complementary mechanisms of action and rationale for the fixed combination of perindopril and indapamide in treating hypertension – update on clinical utility

By Vivencio Barrios and Carlos Escobar

Abstract

Although reducing blood pressure is the most important approach to reduce cardiovascular outcomes in the hypertensive population, the majority of patients fail to attain the targets. Most patients with hypertension need at least 2 antihypertensive agents to achieve blood pressure goals. The 2007 European hypertension guidelines state that combined therapy is needed when monotherapy does not attain blood pressure objectives and as a first-line treatment in high-risk patients. This point has been reinforced in the 2009 update of the European guidelines. The advantages of combination therapy are well documented with the potential for increased antihypertensive efficacy as a result of different mechanisms of action, and a lower incidence of adverse effects because of the lower doses used and the possible compensatory responses. Moreover, the use of fixed dose combinations are specially recommended as they facilitate treatment compliance. The inhibition of the renin-angiotensin system appears to be very beneficial in the treatment of patients with hypertension along the cardiovascular continuum and the combination of a renin-angiotensin system inhibitor and a diuretic is particularly recommended. Many clinical trials have demonstrated the benefits of the fixed combination perindopril/indapamide in the treatment of hypertension. The aim of this manuscript is to update the published data on the efficacy and safety of this fixed combination

Topics: Review
Publisher: Dove Medical Press
OAI identifier: oai:pubmedcentral.nih.gov:3172067
Provided by: PubMed Central

To submit an update or takedown request for this paper, please submit an Update/Correction/Removal Request.

Suggested articles

Citations

  1. A meta-analysis of the effects of treatment on left ventricular mass in essential hypertension.
  2. (2006). A review of Perindopril in the reduction of cardiovascular events.Vasc Health Risk Manag.
  3. (2004). A systematic review and meta-analysis of the efficacy and safety of a fixed, low-dose perindopril-indapamide combination as first-line treatment of hypertension. Clin Ther.
  4. ADVANCE Collaborative Group. Efficacy and safety of fixed combination of perindopril and indapamide in type 2 diabetes: results from ADVANCE in context of available evidence. J Hypertens. 2008;26 Suppl 3:S23–S30.
  5. ADVANCE Collaborative Group. Risks of cardiovascular events and effects of routine blood pressure lowering among patients with type 2 diabetes and atrial fibrillation: results of the ADVANCE study.
  6. (2007). Ambulatory blood pressure in hypertensive patients with left ventricular hypertrophy: efficacy of first-line combination perindopril/indapamide therapy. Vasc Health Risk Manag.
  7. (2004). Angiotensin II: an amplifier of cardiovascular risk. Curr Hypertens Rep.
  8. (2009). Angiotensin-converting enzyme inhibition by perindopril in the treatment of cardiovascular disease. Expert Rev Cardiovasc Ther.
  9. (2009). Angiotensin-converting enzyme inhibitors and atherosclerotic plaque: a key role in the cardiovascular protection of patients with coronary artery disease. Eur Heart
  10. (2008). Application in the STRATHE trial of a score system to compare the efficacy and the tolerability of different therapeutic strategies in the management of hypertension. Vasc Health Risk Manag.
  11. awareness, treatment, and control of hypertension among United States adults 1999–2004.
  12. Benazepril plus amlodipine or hydrochlorothiazide for hypertension in high-risk patients.
  13. (2007). Blood pressure and lipid goal attainment in the hypertensive population in the primary care setting in Spain. J Clin Hypertens
  14. Blood pressure control among treated hypertensive patients by Primary Care
  15. Blood pressure control and improved cardiovascular outcomes
  16. Blood Pressure in Spain: distribution, awareness, control and benefits of a reduction in average pressure.
  17. (2008). Blood pressure normalization by fixed perindopril/indapamide combination in hypertensive patients with or without associate metabolic syndrome: results of the OPTIMAX 2 study. Vasc Health Risk Manag.
  18. Blood pressure, stroke, and coronary heart disease. Part 2, Short-term reductions in blood pressure: overview of randomised drug trials in their epidemiological context.
  19. (2007). Cardiovascular risk profile of uncontrolled hypertensive patients. The Control-Project study. Med Clin (Barc).
  20. Clinical experience with a low-dose fixed combination of perindopril plus indapamide in a primary-care setting: the PRETEND study.
  21. (2009). Combined effects of routine blood pressure lowering and intensive glucose control on macrovascular and microvascular outcomes in patients with type 2 diabetes: New results from the ADVANCE trial. Diabetes Care.
  22. Combining renin-angiotensin-aldosterone system blockade with diuretic therapy for treatment of hypertension.
  23. (2004). Comparison of different therapeutic strategies in hypertension: a low-dose combination of perindopril/indapamide versus a sequential monotherapy or a stepped-care approach. J Hypertens.
  24. controlled trials, observational studies, and the hierarchy of research designs.
  25. (2007). CONTROLRISK Investigators Cardiovascular risk profile and risk stratification of the hypertensive population attended by general practitioners and specialists in Spain. The CONTROLRISK study. J Hum Hypertens.
  26. (2006). Data sheet. In Information for health professionals. http://www.medsafe.govt.nz/profs/datasheet/c/CoversylPlustab.htm. Last update
  27. Effect of low-dose perindopril/ indapamide on albuminuria in diabetes: preterax in albuminuria regression:
  28. Effects of a fixed combination of perindopril and indapamide on macrovascular and microvascular outcomes in patients with type 2 diabetes mellitus (the ADVANCE trial): a randomised controlled trial.
  29. Effects of blood pressure lowering and intensive glucose control on the incidence and progression of retinopathy in patients with type 2 diabetes mellitus: a randomised controlled trial.
  30. Efficacy of a very-low-dose combination of perindopril and indapamide – preterax compared with cilazapril monotherapy in patients with inadequate blood pressure control – a randomized, double-blind, add-on study.
  31. (2008). Electrocardiographic left ventricular hypertrophy regression induced by an angiotensin receptor blocker-based regimen in hypertensive patients with the metabolic syndrome: data from the SARA Study. J Clin Hypertens
  32. (2003). Endothelial dysfunction: a marker of atherosclerotic risk. Arterioscler Thromb Vasc Biol.
  33. (2002). Endothelial function. From vascular biology to clinical applications.
  34. EUROASPIRE Study Group. Cardiovascular prevention guidelines in daily practice: a comparison of EUROASPIRE I, II, and III surveys in eight European countries.
  35. (2007). Evolution of blood pressure control in
  36. (2007). External validity of clinical trials in acute myocardial infarction. Arch Intern Med.
  37. Fixed-dose combinations improve medication compliance: a meta-analysis.
  38. for the Hearth Outcomes Prevention Evaluation (HOPE) Study Group. Effects of angiotensin-converting enzyme inhibitor, ramipril, on cardiovascular events in high-risk patients.
  39. for the PROGRESS Collaborative Group. Perindopril-based blood pressure lowering reduces major vascular events in Asian and Western participants with cerebrovascular disease: the PROGRESS trial.
  40. Group. Effects of a perindopril-based blood pressure lowering regimen on cardiac outcomes among patients with cerebrovascular disease.
  41. Group. Randomised trial of a perindopril-based blood-pressure-lowering regimen among 6,105 individuals with previous stroke or transient ischaemic attack.
  42. (2007). Guidelines for the management of arterial hypertension: The task force for the management of arterial hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC).
  43. (2007). Guidelines on diabetes, pre-diabetes, and cardiovascular diseases: Executive summary.
  44. HYVET Study Group. Treatment of hypertension in patients 80 years of age or older.
  45. Indapamide sustained release: a review of its use in the treatment of hypertension.
  46. Large and small artery endothelial function in patients with essential hypertension – effect of ACE inhibition and beta-blockade.
  47. (2008). Low-dose fixed combination of perindopril plus indapamide in the diabetic hypertensive population. Expert Rev Cardiovasc Ther.
  48. Microalbuminuria in hypertensive patients with electrocardiographic left ventricular hypertrophy: the Losartan Intervention For Endpoint reduction in hypertension (LIFE) study.
  49. Mortality attributable to cardiovascular risk factors in Spain.
  50. (2009). New therapeutic progress in the cardio-renal protection of the hypertensive patient with a focus on olmesartan. Hot Topics in Hypertension.
  51. Normal systolic blood pressure and risk of heart failure in US male physicians.
  52. (2007). Outpatient hypertension treatment, treatment intensification, and control in Western Europe and the United States. Arch Intern Med.
  53. Perindopril/indapamide 2/0.625 mg/day: a review of its place in the management of hypertension.
  54. Perindopril/indapamide combination more effective than enalapril in reducing blood pressure and left ventricular mass: the PICXEL study.
  55. (2000). Pharmacokinetics of sustained and immediate release formulations of indapamide after single and repeated oral administration in healthy volunteers. Fundam Clin Pharmacol.
  56. PRATIK study investigators. Hypertension in high-risk patients: beware of the underuse of effective combination therapy (results of the PRATIK study).
  57. Prognostic impact of coronary vasodilator dysfunction on adverse long-term outcome of coronary heart disease.
  58. (1990). Prognostic implications of echocardiographically determined left ventricular mass in the Framingham Heart Study.
  59. Rationale for fixed-dose combinations in the treatment of hypertension: the cycle repeats.
  60. (2009). Reappraisal of European guidelines on hypertension management: a European Society of Hypertension Task Force document. J Hypertens.
  61. The ADVANCE trial: clarifying the role of perindopril/indapamide fixed-dose combination in the reduction of cardiovascular and renal events in patients with diabetes mellitus.
  62. (2009). The consistency of the treatment effect of an ACE-inhibitor based treatment regimen in patients with vascular disease or high risk of vascular disease: a combined analysis of individual data of ADVANCE, EUROPA, and PROGRESS trials. Eur Heart J.
  63. The role of non-haemodynamic factors of the genesis of LVH.