Effectiveness and Safety of Fixed-dose Combination of Perindopril/Amlodipine/Indapamide, and Telmisartan/Amlodipine/Chlorthalidone in Grade 2 Hypertensive Patients at High Cardiovascular Risk: A Real-world Observational Study
Published: January 1, 2023 | DOI: https://doi.org/10.7860/JCDR/2023/58211.17345
Shambo Samrat Samajdar, Shatavisa Mukherjee, Santanu Kumar Tripathi, Jyotirmoy Pal, Shashank Joshi
1. Clinical Pharmacologist, Department of Clinical and Experimental Pharmacology, School of Tropical Medicine, Kolkata, West Bengal, India.
2. Assistant Professor, Department of Clinical and Experimental Pharmacology, School of Tropical Medicine, Kolkata, West Bengal, India.
3. Dean and Professor, Department of Pharmacology, Netaji Subhash Medical College and Hospital, Patna, Bihar, India.
4. Professor, Department of Medicine, R G Kar Medical College and Hospital, Kolkata, West Bengal, India.
5. Senior Consultant Endocrinologist, Department of Endocrinology, Joshi Clinic, Mumbai, Maharashtra, India.
Correspondence
Dr. Shambo Samrat Samajdar,
Consultant at Diabetes and Allergy-Asthma Therapeutics Specialty Clinic; Department of Clinical and Experimental Pharmacology, School of Tropical Medicine, Kolkata, West bengal, India.
E-mail: drshambosamajdar@gmail.com
Introduction: Fixed-dose combination containing triple antihypertensive agents (Angiotensin-Converting Enzyme Inhibitor (ACE-I)/Angiotensin Receptor Blocker (ARB), diuretic and Calcium Channel Blocker (CCB) is recommended to achieve target Blood-Pressure (BP). However, none of the study has compared ACE-I based and ARB-based triple fixed dose combinations.
Aim: To evaluate the effectiveness and safety of fixed-dose combination of Perindopril (Per)/Amlodipine (Aml)/Indapamide (Ind) and Telmisartan (Tel)/Aml/Chlorthalidone (Chl) in grade 2 hypertensive patients at high Cardiovascular (CV) risk.
Materials and Methods: This retrospective, observational, single-centre study enrolled treatment-naïve grade 2 hypertensive patients who were at high CV risk and were treated with ACE-I based (Per/Aml/Ind group) or ARB-based (Tel/Aml/Chl group) triple fixed-dose combination for atleast one-month at the study centre. Office Blood Pressure (BP) at one-month follow-up was used as a parameter to measure treatment effectiveness. Safety was assessed based on the occurrence of Adverse Events (AEs).
Results: A total of 69 patients (n=32 in Per/Aml/Ind group and n=37 in Tel/Aml/Chl group) were included. Office Systolic BP (SBP)/Diastolic BP (DBP) were 181.44±8.52/95.19±7.25 mmHg and 183.32±6.65/94.81±7.14 mmHg in patients belonging to Per/Aml/Ind and Tel/Aml/Chl groups, respectively. There was a significant reduction in office SBP/DBP at one-month follow-up (Per/Aml/Ind: 129.31±6.44/75.06±4.85 mmHg and Tel/Aml/Chl: 129.10±5.90/75.00±4.82 mmHg; p-value=0.0001). Between-group comparisons did not showed any significant difference in terms of reducing office BP. Both groups exhibited identical safety profile.
Conclusion: The study demonstrated comparable treatment effectiveness and safety profile with triple fixed dose combinations containing Per/Aml/Ind and Tel/Aml/Chl in a real-world setting.
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