A single combination pill of perindopril, indapamide and amlodipine – is it effective in patients with hypertension?

This study investigated the effectiveness of a pill combining perindopril, indapamide and amlodipine (PD/IN/AM) in the treatment of hypertension. They found that PD/IN/AM single combination pill quickly reduced blood pressure with high adherence. 

Hypertension or high blood pressure (BP) is a serious condition. High BP is linked to other serious events and diseases. These include heart attack, stroke, and diabetes. Managing BP can be difficult long-term. Anti-hypertensives (AHTs) are drugs used to treat hypertension. Some patients may require several different AHTs. This is because there are different types of AHTs. Each type has specific targets. By using multiple AHTs, BP can be better managed. 

There are challenges to patients taking multiple AHTs. Adherence is the term to describe how accurately a patient takes their medication. If there is low adherence then treatment may not be effective. Patients taking multiple drugs can have problems with adherence. Recently, combined pills (CMPL) have been developed to simplify treatment and improve adherence. PD/IN/AM is a CMPL of perindopril, indapamide, and amlodipine. It is unclear if this CMPL is safe and effective in treating hypertension. 

This study included 2285 patients with hypertension. Patients were prescribed a dose of PD/IN/AM as necessary by their doctor. Some patients (397) had their dose changed as needed. Patients were assessed at the beginning of the study. Follow-up assessment was done at 1 month and 4 months.  Adherence and BP were measured.

Adherence was high at both post-treatment visits. PD/IN/AM treatment reduced BP levels at 1 and 4 months. At baseline, 3% of patients had normal or high normal BP. At 1 month this increased to 56.6%. At 4 months this increased to 82%. Reductions in BP were observed in patients with varying degrees of hypertension (stage 1-3). Side effects related to treatment were reported by 34 (1.4%) of all patients. The most common side effect was swelling in the lower limb. 

The authors concluded that PD/IN/AM single pill quickly reduced blood pressure with high adherence.

This was a relatively short study. Long-term studies will need to investigate if adherence to PD/IN/AM is maintained. 

If you have any concerns regarding hypertension treatment, please consult with your physician.