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The aimwas to conduct a retrospective consumption analysis of 4 groups of single pill combinations for hypertension treatment and identify potential candidates for future inclusion in the reimbursement list in Ukraine, based on retrospective consumption patterns. Materials and methods:The objects of the study were retail sales data in pharmaceutical market in Ukraine of four groups of single pill combinations used for arterial hypertension treatment. Data was provided by the marker research system “Pharmstandard” of the company of “Morion”. Analytic-comparative, systematic, logical, and mathematical-statistical methods were used. Results:Single pill combinations of ACE inhibitors with diuretics were the most consumed among other combinations on 2018-2020. Retrospective evaluation of consumption patterns in period of 2018-2020 showed that combinations of captopril and hydrochlorothiazide (HCTD) 50 mg/25 mg, enalapril and HCTD 10 mg/25 mg, lisinopril and HCTD 10 mg/12.5 mg were the most consumed. Among ARB and diuretics combinations valsartan and HTCD (160 mg/12.5 mg and 80 mg/12.5 mg) and losartan and HTCD (50 mg /12.5 mg) were the most consumed among ARB and diuretics combinations. Within ACE inhibitors and calcium channel blockers (CCB) combinations the most consumed were lisinopril/amlodipine 10 mg/5 mg and a perindopril arginine/amlodipine 5 mg/5 mg. Valsartan and amlodipine holds the majority among ARC and CCB combinations, consumed in period of 2018-2020. Conclusion:Apart from the single pill combinations, enlisted in the WHO Essential medicines list, eight more single pill combination were identified, based on retrospective consumption patterns, as potential candidates for further inclusion in the reimbursement list in Ukraine

Blood pressure control remains an unmet clinical need. Only about half of patients achieve their blood pressure (BP) targets and of these, the majority require combination and double or triple therapies. International guidelines recommend the association of drugs with complementary mechanisms of action and, in particular, the combination of renin-angiotensin system (RAS) inhibitors, calcium channel blockers (CCBs), and diuretics. Among the various angiotensin receptor blockers, olmesartan (OM) is available as a monotherapy and in dual and triple single-pill combinations (SPCs) with amlodipine (AML) and/or hydrochlorothiazide (HCTZ). Several phase III and IV studies, together with real-world studies, have demonstrated the additional benefits of combining OM either with AML or with HCTZ in terms of BP control and target BP achievements both in the general population and in special subgroups of hypertensive patients, such as the elderly, diabetic, chronic kidney disease or obese patients. Ambulatory BP monitoring studies assessing 24h BP have also demonstrated that dual, as well as triple, OM-based SPCs induce a more sustained and smoother BP reduction than placebo and monotherapy. Furthermore, triple OM-based SPC has been shown to improve therapeutic adherence in hypertensive patients compared to free combinations. The availability of OM combined with HCTZ, AML or both at different dosages makes it a valuable option to customize therapy based on the levels of BP and the clinical characteristics of hypertensive patients.

Various single‐pill combinations (SPCs) have been introduced to improve drug compliance and clinical efficacy. However, there is a lack of real‐world evidence regarding the effectiveness of these SPCs for hypertension. This study evaluated the real‐world clinical efficacy and safety of amlodipine/losartan‐based SPC therapies in patients with hypertension in a real‐world setting. A total of 15 538 patients treated with amlodipine/losartan‐based SPCs [amlodipine + losartan (AL), amlodipine + losartan + rosuvastatin (ALR), and amlodipine + losartan + chlorthalidone (ALC)] were selected from the database of three tertiary hospitals in Korea. The efficacy endpoints were target blood pressure (BP) and low‐density lipoprotein cholesterol (LDL‐C) achievement rates. Safety was evaluated based on laboratory parameters. Drug adherence was defined as the proportion of medication days covered (PDC). The target BP attainment rate was above 90% and was similar among the three groups. Although many patients in the AL and ALC groups took statins, the target LDL‐C attainment rate was significantly higher in the ALR group than in the AL and ALC groups. Safety endpoints were not significantly different among the groups, except serum uric acid level and incidence rate of new‐onset hyperuricemia, which were significantly lower in the AL and ALR groups than in the ALC group. The PDC was > 90% in all groups. In the real‐world hypertensive patients, amlodipine/losartan‐based SPC therapy demonstrated good target BP achievement rates. Especially, rosuvastatin‐combination SPC showed better target LDL‐C goal achievement rate compared to the other SPCs. All three amlodipine/losartan‐based SPC had excellent drug adherence.

On the verge of the second decade of our millennium, controlled hypertension was estimated at the range of approximately 30% to 50% among those European middle-age and older patients who were already treated. Experts agree that non-adherence to pharmacotherapy and physician-related clinical inertia are the utmost challenge in hypertension management. Although treatment with blood pressure lowering drugs with single pill combination (SPC) offers effective solution to that challenge, share of patients using SPC formulation is way under expectations. Few months of COVID-19 pandemic and repetitive lock-downs negatively impacted health condition of the whole societies. Experts report that overall cardiovascular risk profile of majority of patients worsened essentially over the course of several months of pandemic. Aggravated cardiovascular risk factors which clustered with uncontrolled hypertension calls for immediate action. Robust advocacy for wide use of SPC formulation composed of long-acting blood pressure lowering agents appears to be effective and timely getaway from this snare.

Aim. To study the prevalence of comorbidity affecting the choice of antihypertensive treatment, as well as the efficacy and safety of the application of a single pill combination of lysinopril, amlodipine and rosuvastatin (SPC LAR) in hypertensive patients.Material and methods. Observational epidemiological study with the participation of 626 doctors and 13037 hypertensive patients with high cardiovascular risk and dyslipidemia treated with SPC LAR were held in 24 cities of Russia from November 2020 to March 2021. Prevalence and types of comorbidity, changes of blood pressure (BP), of total cholesterol (TC) and blood glucose levels and adverse events were studied during observation. Patients had 3 visits – initially, after 4 and 12 weeks. The obtained data was recorded by doctors through a web portal.Results. Concominant cardiovascular diseases found in all patients (in 38.7% of cases – from 2 to 5 diseases). The most commonly diseases were coronary artery disease (43.1%), metabolic syndrome (36.6%), diabetes (25.2%), chronic heart failure (24.9%), cerebrovascular diseases (12.3%) and chronic obstructive pulmonary disease (0.5%). SPC LAR with minimal doses of components (in 41.1% of patients) or with reinforced antihypertensive or hypocholesterolemic effects, based on the experience of treatment, the patient was prescribed as starting treatment with doctors. Reducing the level of systolic and diastolic BP, as well as the level Tc, respectively, by 20.9%, 16.9% and 29.7% found during the study. Target levels of systolic BP were achieved in 97.6% of patients, diastolic BP – in 99.6%, and target levels TC ≤5 mmol/l, ≤4 mmol/l and ≤3 mmol/l were achieved, respectively, in 94.5%, 68.6% and 23.5% patients. No significant dynamics of the level of glycemia were not found. The treatment was well tolerated by patients. Side effects found in 0.53% of patients (more often there was a dry cough, feet edema and headache). Commitment to treatment was 92.7%.Conclusion. The modern hypertension phenotype has cardiovascular atherosclerosis-associated diseases, which justifies the need to combine antihypertensive and hypolipidemic therapy. Triple SPC LAR, which effectively controlled the blood pressure and improved the violation of lipid metabolism was prescribed to patients in this observational study. The low frequency of side effects and good tolerance of treatment was accompanied by a high adherence of patients to treatment.

The aim was to conduct a retrospective consumption analysis of 4 groups of single pill combinations for hypertension treatment and identify potential candidates for future inclusion in the reimbursement list in Ukraine, based on retrospective consumption patterns. Materials and methods: The objects of the study were retail sales data in pharmaceutical market in Ukraine of four groups of single pill combinations used for arterial hypertension treatment. Data was provided by the marker research system “Pharmstandard” of the company of “Morion”. Analytic-comparative, systematic, logical, and mathematical-statistical methods were used. Results: Single pill combinations of ACE inhibitors with diuretics were the most consumed among other combinations on 2018-2020. Retrospective evaluation of consumption patterns in period of 2018-2020 showed that combinations of captopril and hydrochlorothiazide (HCTD) 50 mg/25 mg, enalapril and HCTD 10 mg/25 mg, lisinopril and HCTD 10 mg/12.5 mg were the most consumed. Among ARB and diuretics combinations valsartan and HTCD (160 mg/12.5 mg and 80 mg/12.5 mg) and losartan and HTCD (50 mg /12.5 mg) were the most consumed among ARB and diuretics combinations. Within ACE inhibitors and calcium channel blockers (CCB) combinations the most consumed were lisinopril/amlodipine 10 mg/5 mg and a perindopril arginine/amlodipine 5 mg/5 mg. Valsartan and amlodipine holds the majority among ARC and CCB combinations, consumed in period of 2018-2020. Conclusion: Apart from the single pill combinations, enlisted in the WHO Essential medicines list, eight more single pill combination were identified, based on retrospective consumption patterns, as potential candidates for further inclusion in the reimbursement list in Ukraine, Мета: провести ретроспективне дослідження споживання 4 груп комбінованих лікарських засобів та визначити їх структуру, з урахування діючих речовин та їх доз, визначити найбільш споживані фіксовані дози комбінованих ЛЗ задля розробки пропозицій, для подальшого проведення клініко-економічних досліджень щодо їх використання в контексті розширення переліку ЛЗ, які підлягають реімбурсації, комбінованими ЛЗ для лікування АГ. Матеріали та методи: об’єктами дослідження були дані роздрібних продажів за період 2018-2020 років на фармацевтичному ринку України чотирьох груп комбінованих антигіпертензивних лікарських засобів. Дані були надані системою вивчення фармацевтичного ринку України «Фармстандарт» компанії «Моріон». У дослідженні використовувались статистично-математичні методи, а також контент-аналізу, порівняльного, логічного та системного аналізу та узагальнення даних. Результати показали, що комбіновані ЛЗ іАПФ та діуретиків є найбільш споживаними серед всіх двокомпонентних комбінованих ЛЗ для лікування АГ в Україні в 2018–2020 роках. За медіаною частки споживання, наступні фіксовані дози комбінацій каптоприл/ГХТЗ (50 мг/25 мг) медіана 29,35 %; еналаприл/ГХТЗ (10 мг/25 мг) медіана 15,89 %; лізиноприл/ГХТЗ (10 мг/12,5 мг) медіана 14,28 % поміж комбінацій іАПФ та діуретиків; валсартан/ГХТЗ (160 мг/12,5 мг (медіана 40,65 %); та 80 мг/12,5 мг (медіана 26,24 %;); лозартан/ГХТЗ (50 мг/12,5 мг) медіана 18,55 % серед комбінацій БРА та діуретиків; лізиноприл/амлодипін (10 мг/5 мг) медіана 36,6 %; периндоприл аргінін та амлодипін (5 мг/5 мг) медіана 13,77 %; та (10 мг/10 мг) медіана 8,61 % зі всіх комбінацій іАПФ та БКК; а також валсартан/амлодипін, в усіх трьох наявних дозах (160 мг/5 мг, 80 мг/5 мг and 160 мг/10 мг) медіана 46,39 %; 32,01 % та 19,88 % відповідно, серед комбінацій БРА та БКК мали найвищі показники медіани частки споживання в кожній відповідній групі комбінованих ЛЗ та використовувались пацієнтами для лікування АГ в Україні в 2018-2020 роках. Висновки: Результати роздрібних продажів показали, що комбіновані ЛЗ іАПФ та діуретиків, а також комбіновані ЛЗ БРА та діуретики є найбільш споживаними серед всіх двокомпонентних комбінованих ЛЗ для лікування АГ в Україні в 2018-2020 роках. Подальший аналіз структури споживання фіксованих доз комбінацій, з урахуванням діючих речовин та їх доз, дозволило визначити в всередині кожній досліджуваній групі ті фіксовані дозі, які мають найбільші значення медіани частки споживання за три роки. Саме щодо них ми пропонуємо проведення подальших клініко-економічних досліджень щодо їх використання в контексті обговорення питання щодо розширення ними переліку комбінованих ЛЗ для лікування АГ, які підлягають реімбурсації в Україні.

In spite of optimization and simplification of arterial hypertension (AH) treatment, achieving blood pressure (BP) control is still challenging, with most patients requiring combination treatment to achieve target BP. Due to the multifactorial effect of AH, additional prevention of hypertension-mediated end-organ damage and the maintenance of vascular integrity achieved by antihypertensive medications in addition to the BP-lowering effect are beneficial for the optimal reduction of cardiovascular (CV) risk. The aim of VICTORY II, a multicenter, open, prospective clinical study with 100 patients included in the active phase was to assess the safety and the efficacy of single-pill combinations (SPC) of amlodipine/valsartan (Wamlox®) and amlodipine/valsartan/hydrochlorothiazide (Valtricom®) in naïve or previously treated but uncontrolled patients with grade 2 or 3 AH. All patients with grade 2 AH started the treatment with the SPC of amlodipine/valsartan 5 mg/80 mg, which if necessary could be up-titrated step by step to the final option – the SPC of amlodipine/valsartan/hydrochlorothiazide 10/160/12.5 mg to achieve the target levels of BP. Patients with grade 3 AH started the treatment with the SPC of amlodipine/valsartan 5 mg/160 mg, which could be up-titrated step-by-step to the SPC of amlodipine/valsartan/hydrochlorothiazide 10/160/25 mg if necessary to achieve the target levels of BP. In addition to achieving the target office BP in 90% of the patients after 16 weeks of therapy, the amlodipine/valsartan-based treatments also decreased the prevalence of albuminuria and the central aortic pressure, improved vessel elasticity, and exerted a positive effect on the vascular endothelial function through its effect on the markers involved in the endothelial function., Unatoč optimizaciji i pojednostavnjenju liječenja arterijske hipertenzije (AH), postizanje kontrole arterijskoga tlaka (AT) i dalje je izazov, a većini je bolesnika potrebno kombinirano liječenje da bi postigli ciljnu kontrolu AT-a. Zbog višefaktorskog učinka AH-a, uz smanjenje vrijednosti AT-a, dodatna prevencija oštećenja ciljnih organa te održavanje vaskularnog integriteta postignuta antihipertenzivima korisni su za optimalno smanjenje kardiovaskularnog (KV) rizika. Cilj multicentričnog, otvorenog, prospektivnog kliničkog ispitivanja VICTORY II u 100 bolesnika uključenih u aktivnu fazu bio je procijeniti sigurnost i djelotvornost fiksnih kombinacija amlodipina/valsartana (Wamlox®) i amlodipina/valsartana/ hidroklorotiazida (Valtricom®) u prethodno neliječenih ili prethodno liječenih bolesnika s AH-om 2. ili 3. stupnja u kojih nije postignuta kontrola vrijednosti AT-a. Svi bolesnici s AH-om 2. stupnja započeli su liječenje fiksnom kombinacijom amlodipina/ valsartana 5 mg / 80 mg, koja se po potrebi mogla titrirati naviše korak po korak do konačne opcije – fiksne kombinacije amlodipina/valsartana/hidroklorotiazida 10/160/12,5 mg kako bi se postigle ciljne vrijednosti AT-a. Bolesnici s AH-om 3. stupnja započeli su liječenje fiksnom kombinacijom amlodipina/valsartana 5 mg / 160 mg, koja se po potrebi mogla titrirati naviše korak po korak do fiksne kombinacije amlodipina/valsartana/hidroklorotiazida 10/160/25 mg kako bi se postigle ciljne vrijednosti. Uz postizanje ciljne vrijednosti AT-a mjerena u ordinaciji, u 90 % bolesnika nakon 16 tjedana liječenja, terapije na bazi kombinacije amlodipina/valsartana također su smanjile prevalenciju albuminurije i centralnoga aortalnog tlaka, poboljšale elastičnost krvnih žila i pokazale pozitivan učinak na funkciju vaskularnog endotela putem svojeg djelovanja na markere uključene u funkciju endotela.

In polish population many patients with comorbid hypertension and hypercholesterolemia present low compliance and adherence to medical advising. The achievement of therapeutic goals of blood pressure control and hypercholesterolemia control was about 5,4% in WOBASZ II study. The therapy with antihypertensive drugs and statin in a single-pill combination (SPC) has recently been strengthened in the European and Polish guidelines for the treatment of arterial hypertension and hypercholesterolemia. It seems that therapy induction with SPC by reducing the number of pills to be taken daily could contribute to solve the problem of not undertaking or discontinuing treatment. The combination product present in different doses give possibility of optimization treatment. The use SCP on a larger scale could improve blood pressure control and cholesterol concentration reduction and prevent many of cardiovascular events.

Various single-pill combinations (SPCs) have been introduced to improve drug compliance and clinical efficacy. However, there is a lack of real-world evidence regarding the effectiveness of these SPCs for hypertension. This study evaluated the real-world clinical efficacy and safety of amlodipine/losartan-based SPC therapies in patients with hypertension in a real-world setting. A total of 15 538 patients treated with amlodipine/losartan-based SPCs [amlodipine + losartan (AL), amlodipine + losartan + rosuvastatin (ALR), and amlodipine + losartan + chlorthalidone (ALC)] were selected from the database of three tertiary hospitals in Korea. The efficacy endpoints were target blood pressure (BP) and low-density lipoprotein cholesterol (LDL-C) achievement rates. Safety was evaluated based on laboratory parameters. Drug adherence was defined as the proportion of medication days covered (PDC). The target BP attainment rate was above 90% and was similar among the three groups. Although many patients in the AL and ALC groups took statins, the target LDL-C attainment rate was significantly higher in the ALR group than in the AL and ALC groups. Safety endpoints were not significantly different among the groups, except serum uric acid level and incidence rate of new-onset hyperuricemia, which were significantly lower in the AL and ALR groups than in the ALC group. The PDC was 90% in all groups. In the real-world hypertensive patients, amlodipine/losartan-based SPC therapy demonstrated good target BP achievement rates. Especially, rosuvastatin-combination SPC showed better target LDL-C goal achievement rate compared to the other SPCs. All three amlodipine/losartan-based SPC had excellent drug adherence.

The health effects of both primary or secondary prevention strategies outperform any method used to treat any acute cardiovascular diseases. The paper highlights basic impediments associated with individual implementation of recommended health preserving behaviors and treatments. The most critical barriers limiting possible health benefits of prevention are discussed. The health benefits of the use and popularization among physicians of single pill combination and hybrid therapy are also brought into focus.

Aim. To evaluate the single pill combination with lisinopril, amlodipine and indapamide ability in additional angioprotection achievement in patients with arterial hypertension and high pulse wave velocity (PWV) regardless on previous antihypertensive therapy (AHT).Material and methods. To the open non-randomized study duration 12 weeks 40 patients were included taking triple AHT during 6 months. All participants underwent ambulatory 24 hour blood pressure (BP) monitoring, applanation tonometry (augmentation index and central BP), pulse wave velocity assessment, laboratory tests (HbA1c, serum uric acid, high sensitive C-reactive protein [hsCRP], serum uric acid).Results. We observed additional systolic BP (SBP) and diastolic BP (DBP) reduction by 16.9% and 22.11% on lisinopril, amlodipine and indapamide single pill combination. Lisinopril, amlodipine and indapamide single pill combination decreased 24 h mean SBP by 16.77%, and 24 h mean DBP -23.5% (ABPM data), PWV by 19.7%, augmentation index by 14.81%, central SBP by 11.9% (pConclusion. Lisinopril, amlodipine and indapamide single pill combination provided control BP, arterial elastic properties improving (augmentation index, PWV, central BP) and favorable influence on inflammation and serum uric acid level.

Introduction Cardiovascular diseases (CVD) represent the first cause of mortality in western countries. Hypertension and dyslipidemia are strong risk factors for CVD, and are prevalent either alone or in combination. Although effective substances for the treatment of both factors are available, there is space for optimization of treatment regimens due to poor patient’s adherence to medication, which is usually a combination of several substances. Adherence decreases with the number of pills a patient needs to take. A combination of substances in one single-pill (single pill combination, SPC), might increase adherence, and lead to a better clinical outcome. Aim We conducted a meta-analysis to compare the effect of SPC with that of free-combination treatment (FCT) in patients with either hypertension, dyslipidemia or the combination of both diseases under conditions of daily practice. Methods Studies were identified by searching in PubMed from November 2014 until February 2015. Search criteria focused on trials in identical hypertension and/or dyslipidemia treatment as FCT therapy or as SPC. Adherence and persistence outcome included proportion-of-days-covered (PDC), medication possession ratio (MPR), time-to treatment gap of 30 and 60 days and no treatment gap of 30 days (y/n). Clinical outcomes were all cause hospitalisation, hypertension-related hospitalisation, all cause emergency room visits, hypertension-related emergency room visits, outpatient visits, hypertension-related outpatient visits, and number of patients reaching blood pressure goal. Randomized clinical studies were excluded because they usually do not reflect daily practice. Results 11 out of 1.465 studies met the predefined inclusion criteria. PDC ≥ 80% showed an odds ratio (OR) of 1.78 (95% CI: 1.30–2.45; p = 0.004) after 6 months and an OR of 1.85 (95% CI: 1.71; 2.37; p < 0.001) after ≥ 12 months in favour to the SPC. MPR ≥ 80% after 12 months also was in favour to SPC (OR 2.13; 95% CI: 1.30; 3.47; p = 0.003). Persistence was positively affected by SPC after 6, 12, and 18 months. Time to treatment gap of 60 days resulted in a hazard ratio (HR) of 2.03 (95% CI: 1.77; 2.33, p < 0.001). The use of SPC was associated with a significant improvement in systolic blood pressure reduction, leading to a higher number of patients reaching individual blood pressure goals (FCT vs SPC results in OR = 0.77; 95% CI: 0.69; 0.85, p < 0.001). Outpatient visits, emergency room visits and hospitalisations, both overall and hypertension-related were reduced by SPC: all-cause hospitalisation (SPC vs FCT: 15.0% vs 18.2%, OR 0.79, 95% CI 0.67; 0.94, p = 0.009), all-cause emergency room visits (SPC vs FCT: 25.7% vs 31.4%, OR 0.75, 95% CI 0.65; 0.87, p = 0.001) and hypertension related emergency room visits (SPC vs FCT: 9.7% vs 14.1%, OR 0.65, 95% CI 0.54; 0.80, p < 0.001). Conclusions SPC improved medication adherence and clinical outcome parameter in patients suffering from hypertension and/or dyslipidemia and led to a better clinical outcome compared to FCT under conditions of daily practice.

The home blood pressure control by a single-pill combination of cilnidipine and valsartan (HOPE-Combi) survey sought to evaluate the safety and efficacy of cilnidipine 10 mg/valsartan 80 mg single-pill combination (SPC of Cil/Val) treatment in patients with hypertension for over 12 months. Of 2622 subjects’ data; we analyzed 2572 cases for safety and 2372 cases for efficacy. Adverse drug reaction (ADR) incidence rate was 3.77% (97 of 2572 patients). The frequency of ADRs did not differ between patients aged P P : The SPC of Cil/Val was safe and effective in treating BP of hypertensive patients in real-world settings.

Globally more than 1 billion people have hypertension and it is predicted that because of ageing populations and increasing sedentary lifestyles, this figure will rise to about 1.5 billion by 2025. Elevated blood pressure (BP) is the leading cause of premature death and morbidity due to stroke and ischemic heart disease. Hypertension is also a major risk factor for heart failure, atrial fibrillation, chronic kidney disease, peripheral arterial disease and cognitive decline. This article discusses the current evidencebased treatment guidelines and pressing temporal issues in optimal blood pressure control.

Background: This study was a multicenter, randomized, double-blinded, placebo-controlled phase III clinical trial to investigate the efficacy and safety of an olmesartan/amlodipine single pill plus rosuvastatin combination treatment for patients with concomitant hypertension and dyslipidemia. Methods: Patients with both hypertension and dyslipidemia aged 20–80 were enrolled from 36 tertiary hospitals in Korea from January 2017 to April 2018. Patients were randomized to three groups in a 1:1:0.5 ratio, olmesartan/amlodipine single pill plus rosuvastatin (olme/amlo/rosu) or olmesartan plus rosuvastatin (olme/rosu) or olmesartan/amlodipine single pill (olme/amlo) combination. The primary endpoints were change of sitting systolic blood pressure (sitSBP) from baseline in the olme/amlo/rosu vs. olme/rosu groups and the percentage change of low-density lipoprotein cholesterol (LDL-C) from baseline in the olme/amlo/rosu vs. olme/amlo groups after 8 weeks of treatment. Results: A total of 265 patients were randomized, 106 to olme/amlo/rosu, 106 to olme/rosu and 53 to olme/amlo groups. Baseline characteristics among the three groups did not differ. The mean sitSBP change was significantly larger in the olme/amlo/rosu group with −24.30 ± 12.62 mmHg (from 153.58 ± 10.90 to 129.28 ± 13.58) as compared to the olme/rosu group, −9.72 ± 16.27 mmHg (from 153.71 ± 11.10 to 144.00 ± 18.44 mmHg). The difference in change of sitSBP between the two groups was −14.62± 1.98 mmHg with significance (95% CI −18.51 to −10.73, p < 0.0001). The mean LDL-C reduced significantly in the olme/amlo/rosu group, −52.31 ± 16.63% (from 154.52 ± 30.84 to 72.72 ± 26.08 mg/dL) as compared to the olme/amlo group with no change, −2.98 ± 16.16% (from 160.42 ± 32.05 to 153.81 ± 31.57 mg/dL). Significant difference in change was found in LDL-C between the two groups with −50.10 ± 2.73% (95% CI −55.49 to −44.71, p < 0.0001). Total adverse drug reaction rates were 10.48%, 5.66% and 3.7% in the olme/amlo/rosu, olme/rosu and olme/amlo groups, respectively with no statistical significance among the three groups. Serious adverse drug reactions did not occur. Conclusions: Olmesartan/amlodipine single pill plus rosuvastatin combination treatment for patients with both hypertension and dyslipidemia is effective and safe as compared to either olmesartan plus rosuvastatin or olmesartan plus amlodipine treatment.

Background and aims The role of single pill combination therapy for stroke prevention remains to be established. We explored the perspectives of stroke survivors and healthcare professionals on single pill combination therapy for stroke prevention. Methods We conducted focus groups involving stroke survivors and healthcare professionals. Results We recruited six stroke survivors: four (67%) were female and mean age was 70 ± 12 years; and eight healthcare professionals (three Stroke Consultants, two Nurse Specialists, three General Practitioners). Improved adherence is the main perceived benefit of single pill combination therapy, although concerns exist surrounding less individualised care, unsuitability for use in the acute setting, reduced ability to titrate doses and difficulty identifying the cause of side effects. The clinical stability of patients, alongside single pill combination therapy efficacy, cost, side effect profile and evidence base for impact on risk factors and clinical outcomes are key factors influencing acceptability. Stroke survivors and healthcare professionals feel single pill combination therapy is most suitable for stable patients, although there is no evidence base for its use in this context. Conclusion Stroke healthcare professionals and stroke survivors are most amenable to using single pill combination therapy for stable patients, although its role in this context should be evaluated in studies with risk factor targets and clinical outcomes as endpoints.

Objective: The present observational study evaluated long-term management of hypertension in patients who received treatment with valsartan and amlodipine in a single-pill combination (Val/Aml SPC)...

Aim. To investigate the impact of valsartan/amlodipine single-pill combination (V/A SPC) on arterial stiffness parameters and 24-hours blood pressure (BP) level in the middle-aged patients with stage II grade 1-2 essential arterial hypertension (HT). Material and methods. A group of patients with stage II grade 1-2 HT who had not previously received regular antihypertensive therapy (n=38, age 49.7±7.0 years) was retrospectively formed. All the patients were treated with V/A SPC and all of them achieved target office BP (9.0 from 31.6 to 10.5% (p=0,049). According to an assessment of arterial stiffness the augmentation index decreased significantly by 23.6±8.6% from -23.0±17.1 to -28.9±18.7 (p=0.034. Transthoracic echocardiography data has demonstrated decrease in effective arterial elastance from 1.73±0.35 to 1.60±0.32 mm Hg (p=0.016) and increase in the arterial compliance – from 1.30±0.38 to 1.43±0.34 mm Hg/ml (p=0.049). Conclusions. In naive patients 40-65 years old with stage II grade 1-2 HT antihypertensive therapy with V/A SPC provides effective 24 hours BP control and improves arterial stiffness parameters.

Background This study evaluated the effectiveness of treatment with an indapamide/amlodipine single-pill combination (SPC) in outpatients with uncontrolled isolated systolic hypertension (ISH) aged over 55 years in real-life clinical practice. Methods This was a post-hoc analysis of the subgroup of patients with ISH from ARBALET, a 3-month, multicenter, observational, open-label study conducted in Russia among patients with grade I or II hypertension who were either uncontrolled on previous antihypertensive treatment or treatment-naïve. The effectiveness of indapamide/amlodipine SPC was assessed by the change in office systolic blood pressure (SBP) and the rate of target SBP ( Results The ARBALET study recruited 2217 patients, of whom 626 had ISH and were included in this post-hoc analysis (mean age 66.1 ± 7.8 years; 165 men [26.4%] and 461 women [73.6%]). Target SBP Conclusion This post-hoc analysis of the observational ARBALET study showed that indapamide/amlodipine SPC was associated with significant reductions in BP and high rates of target BP achievement in a broad age range of patients with ISH treated in routine clinical practice. Study registration number ISRCTN40812831.

Introduction Although several studies have shown that a simplified cardiovascular drug treatment leads to better treatment adherence, limited and conflicting findings have been reported on the separate or single-pill combination of the now recommended association between a statin and ezetimibe. We addressed this issue in a large cohort of patients newly treated with statins to whom ezetimibe was additionally administered, either separately or as a single-pill combination. Methods A total of 256,012 patients (age 40–80 years) from the Lombardy Region (Italy) newly treated with statins during 2011–2013 were followed until 2018 to identify those to whom ezetimibe was added. The 2881 and 5351 patients who started a two-pill or a single-pill combination, respectively, of statin and ezetimibe were identified and matched for propensity score. Adherence to drug therapy at 1 year was measured as the ratio between the number of days in which the drug was available and the days of follow-up (the proportion of days covered; PDC). Patients who had a PDC > 75% or

Introduction: The perindopril 3.5 mg /amlodipine 2.5 mg is the only available angiotensin converting enzyme inhibitor and a calcium channel blocker single pill combination (SPC) with market approval as a first-line therapy indication for hypertension. Hypothesis: Effectiveness, tolerability of, and the compliance to this SPC in patients with newly diagnosed hypertension. Methods: National, prospective, open-label, non-interventional study. Patients (n=1179) were initially prescribed the lowest dose SPC perindopril 3.5 mg/amlodipine 2.5 mg with possible up-titration after 4-weeks treatment (to 7/5 mg up to 14/10 mg). Office blood pressure (BP) at baseline, 3 months (M3), 6 months (M6), and the percentage of patients with normalized BP were assessed. Data were stratified by age, systolic BP category at baseline, and diabetic status. Results: Significant early systolic/diastolic BP decreases from baseline (mean±SD) were observed since the first visit: -20.8±14.7/-11.7±9.2 (P Conclusions: The Canadian SIMPLE study confirms the early benefits, tolerability of and compliance to the SPC perindopril/amlodipine 3.5 mg/2.5 mg, with a possibility of up-titration. This supports the guidelines recommendation for SPC use in newly diagnosed patients with hypertension as a first-line therapeutic option in clinical practice.

Objective: Hypertension is a serious health problem in Egypt, with prevalence rate of 17% as reported in 2015. Despite receiving treatment, many do not achieve blood pressure (BP) control. The curr...

Bisher gelang eine Kontrolle des Bluthochdrucks bei weniger als der Halfte der Hypertoniker. Das konnte sich mit der neuen Europaischen Hypertonie-Leitlinie andern, die nun der Mehrzahl der Patienten bereits primar eine Fixdosis-Kombination in einer Tablette empfiehlt.

Introduction We conducted a prospective, non-interventional, multicenter study to examine the effect of a fixed-dose combination of perindopril/amlodipine in patients with arterial hypertension. Methods Patients who were previously untreated or required a change in medication were treated with a fixed combination of perindopril/amlodipine (3.5/2.5 or 7.0/5.0 mg) for 12 weeks. Changes in office, home and ambulatory blood pressure (BP) were recorded. Adherence was assessed by the Hill-Bone medication adherence scale. Results Overall, 1814 patients (mean age 60.0 ± 13.4 years) were included in 614 German practices, and data of 1770 patients were analyzed. At study entry, 97.7% of patients received perindopril/amlodipine at a daily dose of 3.5 mg/2.5 mg, and 47.9% of patients remained on this dose during the study period. Treatment with perindopril/amlodipine decreased mean office BP from 163.7/95.4 to 133.6/80.3 mmHg (p

The aim was to evaluate the efficacy of a single-pill combination of atorvastatin/amlodipine in patients with arterial hypertension, dyslipidemia and moderate to high cardiovascular risk. This prospective study included 243 patients with arterial hypertension, dyslipidemia and moderate to high cardiovascular risk, mean age 63.3±9.8 years. All patients were prescribed a treatment with one of the following doses of a single-pill combination of atorvastatin/amlodipine: 10/5, 10/10, 20/5 or 20/10 mg daily. The follow-up period was 3 months. The mean baseline values of the systolic and diastolic blood pressure were 155.7±16.2 and 92.0±9.2 mm Hg, respectively. At month 3, the respective mean systolic and diastolic blood pressure values were 136.9±26.9 and 80.6±5.1 mm Hg. The mean baseline values of total cholesterol and low-density lipoprotein cholesterol were 6.6±1.2 and 4.4±1.1 mmol/L, respectively. At month 3, the respective mean values of total cholesterol and low-density lipoprotein cholesterol were 5.1±0.9 and 2.9±1.0 mmol/L. Treatment was discontinued in 9 (3.7%) patients due to adverse events. In conclusion, treatment with the single-pill combination of atorvastatin/amlodipine was effective and well tolerated by the patients with arterial hypertension, dyslipidemia and moderate to high cardiovascular risk., Cilj ovoga istraživanja je bio ocijeniti učinkovitost kombinacije atorvastatina/amlodipina u jednoj tableti kod bolesnika s arterijskom hipertenzijom, dislipidemijom i umjerenim do visokim kardiovaskularnim rizikom. Ovo prospektivno istraži­vanje obuhvatilo je 243 bolesnika s arterijskom hipertenzijom, dislipidemijom i umjerenim do visokim kardiovaskularnim rizikom, srednje dobi od 63,3±9,8 godina. Bolesnicima je propisana terapija jednim od sljedećih režima doziranja kombinacije atorvastatina/amlodipina u jednoj tableti: 10/5, 10/10, 20/5 ili 20/10 mg na dan. Razdoblje praćenja bilo je 3 mjeseca. Srednje početne vrijednosti sistoličkog i dijastoličkog tlaka bile su 155,7±16,2 i 92,0±92,0 mm Hg. Krajem 3. mjeseca vrijednosti sistoličkog i dijastoličkog tlaka bile su 136,9±26,9 i 80,6±5,0 mg Hg. Srednje početne vrijednosti ukupnog kolesterola i kolesterola niske gustoće bile su 6,6±1,2 i 4,4±1,1 mmol/L. Krajem 3. mjeseca vrijednosti ukupnog kolesterola i kolesterola niske gustoće bile su 5,1±0,9 i 2,9±1,0 mmol/L. Terapija analiziranom kombinacijom lijekova prekinuta je kod 9 (3,7%) bolesnika zbog neželjenih nuspojava. U zaključku, terapija kombinacijom atorvastatina/amlodipina u jednoj tableti visoko je učinkovita i dobro ju podnose bolesnici s arterijskom hipertenzijom, dislipidemijom i umjerenim do visokim kardiovaskularnim rizikom.

Background It is well established that single pill combination (SPC) therapies have the potential to improve patient adherence versus multi-pill regimens, thereby improving blood pressure control and clinical outcomes in populations with hypertension. Purpose To develop a microsimulation model, capturing different treatment pathways, to project the impact on clinical outcomes of using single pill combination therapies for the management of hypertension in five countries (Italy, Russia, China, South Korea and Mexico). Methods The model was designed to project health outcomes between 2020 and 2030 for populations with hypertension managed according to four different treatment pathways: current treatment practices [CTP], single drug with dosage titration first then sequential addition of other agents [start low and go slow, SLGS], free choice combination with multiple pills [FCC] and combination therapy in the form of a single pill [SPC]. Model inputs were derived from Global Burden of Disease 2017 dataset, including demographics, health status/risk factors, transition probabilities and treatment attributes/healthcare utilization, and the model incorporated real-world challenges to healthcare delivery such as access to care, SBP measurement error, adherence and therapeutic inertia. Simulated outcomes of mortality, incidence of chronic kidney disease (CKD), stroke and ischemic heart disease (IHD), and disability-adjusted life years (DALYs) due to these conditions were estimated for population of 1,000,000 simulated patients for each treatment pathway and country. Results SPC therapy was projected to improve health outcomes over SLGS, FCC and CTP over 10 years in all five countries. SPC was forecast to reduce mortality by 5.4% (Italy), 4.9% (Russia), 4.5% (China), 2.3% (South Korea) and 3.6% (Mexico) versus CTP and showed greater projected reductions in mortality than SLGS and FCC. DALYs were projected to be reduced with SPC therapy by between 5.7% (Italy) and 2.2% (South Korea) compared with CTP and reductions in the incidence of clinical events were also projected with SPC therapy, with decreases in the range of 11.5% (Italy) to 4.9% (South Korea) versus CTP. Conclusions Ten-year projections of clinical outcomes associated with different anti-hypertensive treatment pathways in five countries indicated that both combination therapies (FCC and SPC) are likely to reduce the disease burden of hypertension compared with conventional management approaches, with SPC showing the greatest overall benefits due to improved adherence. Funding Acknowledgement Type of funding source: Private company. Main funding source(s): Sanofi, Gentilly, France