Official journal of the Slovak Society of Cardiology,
Slovak Society of Hypertension and Slovak Association for Cardiac Arrhythmias

Cardiology Letters 2011, 20(3):228-237

Clinical synergy of perindopril arginine and amlodipine combination in hypertension thera

Remková A
Centrum hemostázy a trombózy, HemoMedika Bratislava s.r.o., Slovenská republika

It is known that at least a two-drug antihypertensive combination is necessary in the majority of patients to reach BP goals associated with reduced risk of cardiovascular events. The combination of an ACE inhibitor, perindopril arginine, plus a dihydropyridine calcium channel blocker (CCB), amlodipine, with different and complementary mechanisms of action may achieve additive or synergistic pharmacodynamic interaction resulting in more efficient BP lowering through 24 hours, improved fibrinolytic function and reduction of secondary effects related to the pharmacological properties of each agent. Large outcome trials such as ASCOT-BPLA and its substudies have shown that perindopril/amlodipine strategies combine effective BP lowering with synergistic cardioprotective properties. Various substudies of ASCOT have provided further information on the superior efficacy of the perindopril/amlodipine strategy in patients with a moderate risk of cardiovascular events. This combination is also associated with reduced side effects, which may impact positively on treatment adherence. It appears that the mortality improvements demonstrated for ACE inhibitor/CCB combinations may be drug and/or dose-dependent, rather than class-dependent. While ACE inhibitor/CCB combinations have been examined, the only combination to report a significant reduction in all-cause and cardiovascular mortality in outcome trials is the perindopril plus amlodipine strategy. Perindopril/amlodipine, which is currently the only fixed-dose antihypertensive combination approved in two indications (hypertension and coronary artery disease) is an effective and well-tolerated combination for the management of patients with hypertension, particularly for those at high risk.

Keywords: ACE inhibitors; perindopril; calcium channel blocker; amlodipine; combination therapy

Published: March 1, 2011  Show citation

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Remková A. Clinical synergy of perindopril arginine and amlodipine combination in hypertension thera. Cardiology Letters. 2011;20(3):228-237.
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