Overcoming clinical inertia to achieve blood pressure goals: the role of fixed-dose combination therapy

2009 ◽  
Vol 4 (2) ◽  
pp. 119-127 ◽  
Author(s):  
Jan Basile ◽  
Joel Neutel
Keyword(s):  
Blood Pressure ◽  
Combination Therapy ◽  
Fixed Dose Combination ◽  
Clinical Inertia ◽  
Fixed Dose ◽  
Achieve Blood Pressure ◽  
Dose Combination ◽  
Blood Pressure Goals

scholarly journals A ramipril versus ramipril/amlodipin fix kombináció egyéves perzisztenciája hypertoniás betegekben

2017 ◽  
Vol 158 (42) ◽  
pp. 1669-1673 ◽  
Author(s):  
Gábor Simonyi ◽  
Tamás Ferenci
Keyword(s):  
Blood Pressure ◽  
Survival Analysis ◽  
Combination Therapy ◽  
Fixed Dose Combination ◽  
Fixed Dose ◽  
Hypertensive Patients ◽  
Persistence Rate ◽  
Dose Combination ◽  
One Year ◽  
The One

Abstract: Introduction: In the treatment of hypertension avoiding adverse cardiovascular complications to achieve target blood pressure is essential. The appropriate drug selection, and if necessary to change to combination therapy, patients adherence is important which may help fixed dose combination. Aim: The aim of the authors was to investigate the one year adherence of the ramipril and ramipril/amlodipine fixed dose combination in hypertensive patients. Method: Prescriptions database of the National Health Insurance Fund in Hungary on pharmacy-claims was analysed between October 1, 2012 and September 30, 2013. The authors identified patients who filled prescriptions for ramipril monotherapy and fixed dose combinations of ramipril/amlodipine prescribed for the first time in hypertensive patients who have not received similar drugs in the previous year. To model the adherence, the apparatus of survival analysis was used, where “survival” was the time to abandon the medication. As it was available to month precision, discrete time survival analysis was applied: a generalized linear model was estimated with complementary log-log link function with the kind of drug being the only explanatory variable. Results: 92,546 patients met the inclusion criteria. During the trial period, ramipril therapy or ramipril/amlodipine fixed dose combination was started in 82,251 and 10,295 patients, respectively. One year persistence rate in patients with ramipril was 30% and 54% in patients with ramipril/amlodipine fixed dose combination therapy. Considering only the 360-day study period, the mean duration of persistence was 189.9 days in patients on ramipril and 270.6 days on ramipril/amlodipine fixed dose combination therapy. The hazard of discontinuation was more than twofold higher during treatment with ramipril compared with the use of the ramipril/amlodipine fixed dose combination therapy (HR = 2.11 [95% CI: 2.05–2.17], p<0,001). Conclusions: There is a significant difference between the one year persistence of ramipril and ramipril/amlodipine fixed dose combination therapy in hypertension. The result demonstrated that ramipril/amlodipine fixed dose combination therapy has a better one year persistence rate. When the next step is necessary to achieve target blood pressure, ramipril/amlodipine fixed dose combination therapy is preferable. Orv Hetil. 2017; 158(42): 1668–1673.

scholarly journals Blood pressure control in patients with uncontrolled hypertension by switching from the mono - or combined therapy to the fixed combination of angiotensin II converting enzyme inhibitor and calcium blocker

2012 ◽  
Vol 18 (6) ◽  
pp. 484-490 ◽  
Author(s):  
Y. A. Karpov
Keyword(s):  
Blood Pressure ◽  
Combination Therapy ◽  
Fixed Combination ◽  
Enzyme Inhibitor ◽  
Combined Therapy ◽  
Fixed Dose Combination ◽  
Uncontrolled Hypertension ◽  
Fixed Dose ◽  
Routine Practice ◽  
Dose Combination

Objective. The paper presents the results of the blood pressure (BP) control by switching from unsuccessful monotherapy and combination therapy to fixed combination «perindopril/amlodipine» in the routine practice. Design and methods. PRORYV (BREAK) program included 589 outpatient general practitioners (GPs) and cardiologists from medical and preventive institutions in 50 Russian cities and 4 115 patients with uncontrolled hypertension (HT). PRORYV is an open, multicentered, observational non-comparative study. Inefficient anti-HT therapy (except for treatment with beta-blockers) was cancelled. Results. With fixed-dose combination therapy perindopril/amlodipine BP level lowered from 167,1/97,6 to 130/80,1 mm Hg (by 37,1/17,5 mm Hg) on average in all patients, and the effect was comparable in both males and females, regardless age, coronary artery disease or diabetes. Target BP was achieved in 80 % patients. Results. Switching to fixed-dose combination perindopril/amlodipine (Prestance, Servier, France) from mono- or combination therapy leads to fast and persistent anti-HT effect in all patients with previously uncontrolled BP.

scholarly journals Effect of a fixed-dose combination of perindopril arginine/amlodipine on the level and variability of blood pressure according to its office visit-to-visit measurements and self-measurements at home: A subanalysis of the PREVOSHODSTVO (SUPERIORITY) program

2017 ◽  
Vol 89 (8) ◽  
pp. 29-36
Author(s):  
O D Ostroumova
Keyword(s):  
Blood Pressure ◽  
Combination Therapy ◽  
Patient Group ◽  
Antihypertensive Drugs ◽  
Office Visit ◽  
Fixed Dose Combination ◽  
Uncontrolled Hypertension ◽  
Fixed Dose ◽  
Dose Combination

Aim. To study the effect of a fixed-dose combination of perindopril arginine/amlodipine (prestans) on the goal levels and variability of blood pressure (BP) according to its office visit-to-visit measurements and self-measurement (OVVM and SM) in a subgroup of 483 people from the population of the Russian observational SUPERIORITY program, most cases of whom are given the combination replacing the previously ineffective mono- and combination antihypertensive therapy (AHT). Subjects and methods. The subanalysis included data on 483 patients (34% men) aged 57.9±10.8 years with uncontrolled hypertension, who were both untreated and treated with antihypertensive mono- or combination therapy using a free or fixed-dose combination of 2—3 antihypertensive drugs and in whom the physicians decided to use prestans to correct AHT. The follow-up period was 24 weeks. Results. At the end of the investigation, the patients received prestans in the following doses: 5/5 mg (34% of the patients), 10/5 mg (39.5%), 5/10 mg (3.9%), and 10/10 mg (22%). In the analyzed patient group, the baseline BP was 160.8±8.8/92.6±7.4 mm Hg and dropped to 125.9±7.9/77.8±5.0 mm Hg at 24 weeks (p

Sign in / Sign up

Export Citation Format

Share Document