Perindopril 3.5 mg/amlodipine 2.5 mg versus renin-angiotensin system inhibitor monotherapy as first-line treatment in hypertension: a combined analysis

The high prevalance of hypertension1 and its associated high risk of morbidity and mortality2-4 underscore the need for better strategies to prevent, detect and treat hypertension and, hence reduce cardiovascular outcomes. 

Many patients still are diagnosed with hypertension each year, making rapid and effective control of blood pressure (BP) crucial.   Appropiate first-line treatment is important, and special attentition should be paid to the positive effects of early BP lowering. Perindopril 3.5mg/amlodipine 2.5 mg (P3.5/A2.5) is a single-pill combination suitable for first line treatment. 

Individual patient data from three randomized controlled trials that evaluated the efficacy of P3.5/A2.5 versus RAS-inhibitor monotherapies in patients with hypertension5-7 were used to perform a combined analysis.

In a large population, early administration of P.35/A2.5 resulted in a significantly greater BP-lowering effect than perindopril, irbesartan or valsartan monotherapies after 1 month. Reducing BP levels withing a month of treatment may reasonably be expected to lead to a reduced risk of cardiovascular events. 

Table 1. Mean change from baseline in SBP/DBP after 1 month of treatment with perindopril 3.5 mg/amlodipine 2.5 mg combination versus each of the renin–angiotensin system-inhibitor monotherapies within each study

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