1 / 5

Why fixed-dose combinations in hypertension ?

Why fixed-dose combinations in hypertension ?. Combination therapy is needed when monotherapy does not attain blood pressure objectives and as a first-line treatment in high-risk patients. 2007 and 2009 updates of European hypertension guidelines Advantages of a fixed-dose combination:

fredricka
Download Presentation

Why fixed-dose combinations in hypertension ?

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript


  1. Why fixed-dose combinations in hypertension? • Combination therapy is needed when monotherapy does not attain blood pressure objectives and as a first-line treatment in high-risk patients. 2007 and 2009 updates of European hypertension guidelines • Advantages of a fixed-dose combination: Increased antihypertensive efficacy + lower incidence of adverse events + improved compliance • ACE inihibitor + diuretic combination is very beneficial throughout the cardiovascular continuum, as demonstrated by the perindopril/indapamide combination Barrios V, Escobar C. Integrated Blood pressure Control. 2010:3 11-19.

  2. Superior LVMI reduction with perindopril/indapamideversus enalapril Effect of the combination perindopril/indapamide (2 mg/0.625 mg up to 8 mg/2.5 mg) and enalapril (10 mg up to 40 mg/daily) on left ventricular mass index (g/m2). Data from the PICXEL study. Barrios V, Escobar C. Integrated Blood pressure Control. 2010:3 11-19.

  3. AER reduction greater with perindopril/indapamide versus enalapril Effect of the combination perindopril/indapamide (2 mg/0.625 mg up to 8 mg/2.5 mg) and enalapril (10 mg up to 40 mg/daily) on urinary albumin excretion (% of change from baseline). Data from the PREMIER study. Barrios V, Escobar C. Integrated Blood pressure Control. 2010:3 11-19.

  4. Risk of cardiovascular events reduced in important trials ADVANCE1 Active group vs control PROGRESS2 Active group vs control ACCOMPLISH3,4 Excess risk observed in the hydrochlorothiazide** arm when combined with an ACE inhibitor **HCTZ+ benazepril versus amlodipine + benazepril 1. ADVANCE Collaborative Group. Lancet. 2007;370:829-840. 2. PROGRESS Collaborative Group. Lancet. 2001;358:1033-1041. 3. Jamerson K, Weber MA, Bakris GL, et al; ACCOMPLISH trial investigators. N Engl J Med. 2008;359:2417-2428. 4. Bakris GL, Sarafi dis PA, Weir MR, et al; ACCOMPLISH Trial investigators. Lancet. 2010;375:1173-1181.

  5. Indapamide differs from thiazide diuretics 1. Ambrosioni E, Safar M, Degautec J-P, et al. J Hypertens. 1998;16:1677-1684. 2. Akram J, Sheikh UE, Mahmood M, Donnelly R. Curr Med Res Opin. 2007;23:2929-2936. 3. Messerli FH, Makani H, Benjo A, Romero J, Alviar C, Bangalore S. J Am Coll Cardiol. 2011;57:590-600. 4. Gaciong Z, Symonides B. Expert Opin Pharmacother. 2010;11:2579-2597. 5. Beckett NS, Peters R, Fletcher AE, et al. N Engl J Med. 2008;358:1887-1898. 6. Gosse P, Sheridan DJ, Zannad F, et al. J Hypertens. 2000;18:1465-1475. 7. Marre M, Garcia J, Kokot F, et al. J Hypertens. 2004;22:1613-1622. 8. Pepine CJ, Handberg EM, Cooper-DeHoff R, et al. JAMA. 2003;290:2805-2816.

More Related