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Long-term effect of the perindopril/indapamide/amlodipine single-pill combination on left ventricular hypertrophy in outpatient hypertensive subjects.
- Source :
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Biomedicine & pharmacotherapy = Biomedecine & pharmacotherapie [Biomed Pharmacother] 2019 Dec; Vol. 120, pp. 109539. Date of Electronic Publication: 2019 Oct 15. - Publication Year :
- 2019
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Abstract
- Background: Most antihypertensive drugs used in monotherapy or in combination therapy reduce the left ventricular mass index (LVMI). However, little is known about the effects on LVMI of a triple fixed-dose combination (TFC) therapy, containing in a single pill an angiotensin-converting enzyme inhibitor (ACEI), a diuretic and a calcium channel blocker (CCB).<br />Methods: In this prospective open-label study, 92 patients with essential hypertension were randomized to treatment with a TFC of perindopril/indapamide/amlodipine at different doses or a triple free combination therapy (FCT) including ACEI/diuretic/CCB. Office blood pressure (BP) measurement, 24 h-ambulatory BP monitoring and echocardiography were performed at baseline and during a 14-month follow-up. The BP variability (BPV) over 24 h was calculated as ± standard deviation of the daytime systolic BP. Differences between office and monitored BP and LVMI were evaluated by ANOVA for repeated measures.<br />Results: A significant BP-lowering effect was observed for both treatments. At follow-up, BPV was reduced in both the treatment groups vs. the baseline (14.0±1.5 vs. 17.0±1.8 and 16.2±2.1 vs. 17.6±2.3, respectively), but it was lower in the TFC vs. the FCT group (14.0±1.5 vs. 16.1±2.2, P < 0.05). LVMI was lower in both the treatment groups, but the change was greater for TFC vs. FCT (-8.3±4.9% vs. -2.0 ±2.1%, P < 0.0001). Left ventricular hypertrophy (LVH) regression was greater in the TFC vs. the FCT group (43.5% vs. 30.4%, P < 0.05).<br />Conclusions: Independently of BP values achieved, the antihypertensive TFC therapy was more effective than FCT in LVMI reduction and LVH regression, possibly related to drugs' intrinsic properties and to BPV modulation.<br /> (Copyright © 2019 The Authors. Published by Elsevier Masson SAS.. All rights reserved.)
- Subjects :
- Blood Pressure drug effects
Blood Pressure Monitoring, Ambulatory
Drug Combinations
Female
Follow-Up Studies
Humans
Hypertension physiopathology
Hypertrophy, Left Ventricular physiopathology
Male
Middle Aged
Systole drug effects
Time Factors
Amlodipine therapeutic use
Hypertension complications
Hypertension drug therapy
Hypertrophy, Left Ventricular complications
Hypertrophy, Left Ventricular drug therapy
Indapamide therapeutic use
Outpatients
Perindopril therapeutic use
Subjects
Details
- Language :
- English
- ISSN :
- 1950-6007
- Volume :
- 120
- Database :
- MEDLINE
- Journal :
- Biomedicine & pharmacotherapy = Biomedecine & pharmacotherapie
- Publication Type :
- Academic Journal
- Accession number :
- 31627089
- Full Text :
- https://doi.org/10.1016/j.biopha.2019.109539