Lipertance^® – two problems, one solution

Czech version

Authors: J. Špinar ¹; J. Vítovec ²; L. Špinarová ²
Authors‘ workplace: Interní kardiologická klinika LF MU a FN Brno ¹; I. interní kardioangiologická klinika LF MU a FN u sv. Anny v Brně ²
Published in: Kardiol Rev Int Med 2016, 18(4): 287-292

Overview

Hypertension and dyslipidaemia are the most important risk factors of cardiovascular diseases, which very frequently appear together. About 70% of hypertensive patients suffer from dyslipidaemia. The first line treatment of hypertension are ACE inhibitors and dihydropyridines and the first line treatment for dyslipidaemia are statins. The combination of perindopril + amlodipine was more effective in the treatment cardiovascular events in hypertensive patients than a combination of a beta blocker + diuretic in the ASCOT study, and adding of atorvastatin potentiated this effect. This is a clear evidence of positive effect of the combination atorvastatin + perindopril + amlodipine in the primary prevention. In the EUROPA study, perindopril showed a decrease of cardiovascular events if compared with placebo in patients with ischaemic heart disease, and adding of amlodipine increased this effect. The statin treatment decreases cardiovascular mortality in patients with ischaemic heart disease irrespectively of the cholesterol level. This is clear evidence for the positive effect of the combination atorvastatin + perindopril + amlodipine in secondary prevention. The positive effect of fixed combinations as compared with monotherapies of the same components was repeatedly confirmed especially in studies investigating hypertension. The fixed triple combination of atorvastatin + perindopril arginine + amlodipine increases the adherence of patients to the treatment and this enables a more effective control of both risk factors – hypertension and dyslipidaemia in primary as well as secondary prevention.

Keywords:
hypertension – dyslipidaemia – fixed combinations

Sources

1. Filipovský J, Widimský J jr., Ceral J et al. Diagnostické a léčebné postupy u arteriální hypertenze, verze 2012: Doporučení České společnosti pro hypertenzi. Vnitřní lékařství 2012; 58(10): 785– 801.

2. Mancia G, Fagard R, Narkiewicz K et al. 2013 ESH/ ESC Guidelines for the management of arterial hypertension: the Task Force for the management of arterial hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). J Hypertension 2013; 31(7): 1281– 1357. doi: 10.1097/ 01.hjh. 0000431740.32696.cc.

3. Wolf-Maier K, Cooper RS, Banegas JR et al. Hypertension prevalence and blood pressure levels in 6 European countries, Canada, and the United States. JAMA 2003; 289(18): 2363– 2369.

4. Cífková R, Škodová Z, Bruthans J et al. Longitudinal trends in cardiovascular mortality and blood pressure levels, prevalence, awareness, treatment, and control of hypertension in the Czech population from 1985 to 2007/ 2008. J Hypertens 2010; 28(11): 2196– 2203. doi: 10.1097/ HJH.0b013e32833d4451.

5. Wald DS, Law M, Morris JK et al. Combination therapy versus monotherapy in reducing blood pressure: meta-analysis on 11,000 participants from 42 trials. Am J Med 2009; 122(3): 290– 300. doi: 10.1016/ j.amjmed.2008.09.038.

6. Dahlöf B, Sever PS, Poulter NR et al. The ASCOT Investigators. Prevention of cardiovascular events with an antihypertensive regimen of amlodipine adding perindopril as required versus atenolol adding bendroflumethiazide as required, in the Anglo-Scandinavian Cardiac Outcomes Trial-Blood Pressure Lowering Arm (ASCOT-BPLA): a multicentre randomised controlled trial. Lancet 2005; 366(9489): 895– 906.

7. Bramlage P, Bohm M, Volpe M et al. a global perspective on blood pressure treatment and control in a referred cohort of hypertensive patiens. J Clin Hypertens 2010; 12(9): 666– 677. doi: 10.1111/ j.1751-7176.2010.00322.x.

8. Kettani FZ, Dragomir A, Côté R et al. Impact of a better adherence to antihypertensive agentson cerebrovascular disease for primary prevention. Stroke 2009; 40(1): 213– 220. doi: 10.1161/ STROKEAHA.108.522193.

9. Peters R, Beckett N, Forrete F et al. Incident dementia and blood pressure lowering in the HYpertensiuon in Very Elderly Trial cognitive function assement. Lance Neurol 2008; 7(8): 683– 689. doi: 10.1016/ S1474-4422(08)70143-1.

10. Mancia G, Laurent S, Agabiti-Rosei L et al. Reappraisal of European guidelines on hypertension management: a European Society of hypertension Task Force dokument. J Hypertens 2009; 27(11): 2121– 2158. doi: 10.1097/ HJH.0b013e328333146d.

11. Bangalore S, Kamalakkannan G, Parkar S et al. Fixed-dose combinations improve medication compliance: a meta-analysis. Am J Med 2007; 120(8): 713– 719.

12. Vítovec J, Špinar J. Kombinační léčba hypertenze s přihlédnutím k fixním kombinacím. Kardiol Rev Int Med 2014; 16(6): 71– 74.

13. Špinar J, Vítovec J. Kombinační léčba hypertenze. Causa Subita 2012; 15(1): 10– 13.

14. Souček M, Řiháček I, Fráňa P et al. Léčba hypertenze v rámci metabolického syndromu. Kardiol Rev 2010; 12(2): 73– 76.

15. Nissen SE, Tuzcu EM, Libby P et al. Effect of antihypertensive agents on cardiovascular events in patients with coronary disease and normal blood pressure: the CAMELOT study: a randomized controlled trial. JAMA 2004; 292(18): 2217– 2225.

16. Tatti P, Pahor M, Byington RP et al. Outcome results of the Fosinopril Versus Amlodipine Cardiovascular Events Randomized Trial (FACET) in patients with hypertension and NIDDM. Diabetes Care 1998; 21(4): 597– 603.

17. Tobe S, Kawecka-Jaszcz K, Zannad F et al. Amlodipine added to quinapril vs quinapril alone for the treatment of hypertension in diabetes: the Amlodipine in Diabetes (ANDI) trial. J Clin Hypertens (Greenwich) 2007; 9(2): 120– 127.

18. Dahlöf B, Sever PS, Poulter NR et al. Prevention of cardiovascular events with an antihypertensive regimen of amlodipine adding perindopril as required versus atenolol adding bendroflumethiazide as required, in the Anglo-Scandinavian Cardiac Outcomes Trial-Blood Pressure Lowering Arm (ASCOT-BPLA): a multicentre randomised controlled trial. Lancet 2005; 366(9489): 895– 906.

19. Poulter NR, Wedel H, Dahlöf B et al. Role of blood pressure and other variables in the differential cardiovascular event rates noted in the Anglo-Scandinavian Cardiac Outcomes Trial-Blood Pressure Lowering Arm (ASCOT-BPLA). Lancet 2005; 366(9489): 907– 913.

20. Jamerson K, Weber MA, Bakris GL et al. Benazepril plus amlodipine or hydrochlorothiazide for hypertension in high-risk patients. N Engl J Med 2008; 359(23): 2417– 2428. doi: 10.1056/ NEJMoa0806182.

21. Bakris GL, Sarafidis PA, Weir MR et al. Renal outcomes with different fixed-dose combination therapies in patients with hypertension at high risk for cardiovascular events (ACCOMPLISH): a prespecified secondary analysis of a randomised controlled trial. Lancet 2010; 375(9721): 1173– 1181. doi: 10.1016/ S0140-6736(09)62100-0.

22. Vítovec J, Špinar J. Perindopril/ indapamid – fixní kombinace. Remedia 2007; 17(3): 247– 257.

23. van Vark LC, Bertrand M, Akkerhuis KM et al. Angiotensin-converting enzyme inhibitors reduce mortality in hypertension: a meta-analysis of randomized clinical trials of renin- angiotensin- aldosterone system inhibitors involving 158 998 patients. Eur Heart J 2011; 33(16): 2088– 2097. doi: 10.1093/ eurheartj/ ehs075.

24. Yusuf S, Sleight P, Pogue J et al. Heart Outcomes Prevention Evaluation Study Investigators. Effects of an angiotensin converting-enzyme inhibitor, ramipril, on cardiovascular events in high-risk patients. Heart Outcomes Prevention Evaluation Study Investigators. N Engl J Med 2000; 342(3): 145– 153.

25. Fox KM. EURopean Trial On reduction of cardiac events with Perindopril in stable coronary Artery disease Investigators. Efficacy of perindopril in reduction of cardiovascular events among patients with stable coronary artery disease: randomised, double-blind, placebo-controlled, multicentre trial (the EUROPA study). Lancet 2003; 362(9386): 782– 788.

26. Widimský P. Studie EUROPA: úspěch perindoprilu a české kardiologie. Cor Vasa 2004; 46(1): 7– 8.

27. Borghi C, Morbini M, Cicero AF et al. Combination therapy in the extended cardiovascular continuum a focuc on perindopril and amlodiopine. J Cardiovasc Med 2015; 16(5): 390– 399. doi: 10.2459/ JCM.0000000000000240.

28. Deeks ED. Amlodipine/ valsartan/ hydrochlorothiazide: fixed-dose combination in hypertension. Am J Cardiovasc Drugs 2009; 9(6): 411– 418. doi: 10.2165/ 11204350-000000000-00000.

29. Widimský J jr. První fixní trojkombinace perindopril arginin-indapamid-amlodipin: nový přístup v kombinační léčbě hypertenze. Vnitř Lék 2014; 60(9): 801– 807.

30. Widimský J jr. Trojkombinace v léčbě hypertenze. Kardiol Rev Int Med 2014; 16(6): 449– 453.

31. Widimský J jr. Na český trh přichází vůbec první fixní antihypertenzní trojkombinace. Practicus 2014; 8: 29.

32. Toth K. Antihypertensive efficacy of triple-combination Perindopril-Indapamide plus Amlodipine in high risk hypertensive patients(PIANIST study). Am J Cardiovasc Drugs 2014; 14(2): 137– 145. doi: 10.1007/ s40256-014-0067-2.

33. Špinar J, Vítovec J, Špinarová L. Fixní kombinační léčba hypertenze. Kardiol Rev Int Med 2016; 18(2): 85– 93.

34. Rosolová H. Význam fixní kombinace atorvastatin, perindopril a amlodipin (Lipertance). Farmakoterapie 2016; 4: 484– 489.

35. Widimský J jr. Lipertance – první fixní trojkombinace atorvastatinu, perindopril argininu a amlodipinu. Hypertenze a kardiovaskulární prevence 2016; 2: 63– 66.

36. Zafarová Z. Lipertance – jeden krok v léčbě kardiovaskulárního rizika, aneb nikdy to nebylo jednodušší. Cor Vasa 2016; 58(5): 648– 652.