Is perindopril with amlodipine a new promising drug treatment strategy for reducing high blood pressure?

This study looked at whether the drug combination of amlodipine (Norvasc) and perindopril (Aceon), given at increasing doses, is successful in reducing high blood pressure. 

Hypertension (high blood pressure) refers to when pressure inside the blood vessels is too high. This causes the heart to have to work harder in order to pump blood against the extra pressure. Uncontrolled hypertension increases the risk of serious health problems, such as heart attack and stroke.

Treatment for hypertension includes the use of antihypertensive drugs. Most often, a combination of at least two different antihypertensive drugs is needed to successfully lower blood pressure.

Some examples of antihypertensive drugs include angiotensin converting enzyme (ACE) inhibitors such as perindopril (Aceon), calcium channel blockers such as amlodipine (Norvasc), or angiotensin receptor blockers (ARBs) such as valsartan (Diovan).

However, despite taking antihypertensive drugs, there is still an overwhelming number of patients that have uncontrolled high blood pressure. Therefore, new combinations and doses of drugs are being tested to find the best strategy to successfully reduce high blood pressure. 

This study investigated whether combining amlodipine with perindopril is effective at reducing high blood pressure. The impact of this drug combination was compared with amlodipine and valsartan together, as valsartan is widely used and has few side effects.

A total of 881 patients were included in the amlodipine/perindopril group, and 876 patients were in the amlodipine/valsartan group. The average age of patients was 56 years and average blood pressure was 163/100 mmHg (normal blood pressure is considered to be 120/80 mmHg). 

Patients began taking low daily doses of perindopril and amlodipine. If blood pressure was still too high after 1 month of treatment, the dose of each drug was increased, and likewise after the 2^nd and 3^rd months. The doses included perindopril being given at 3.5, 7, and 14 mg and amlodipine being given at doses 2.5, 5, and 10 mg. Valsartan was given at a dose of 80 mg or 160 mg with 5 or 10 mg of amlodipine.

It was found that after 1 month, 33% of patients in the perindopril/amlodipine group had controlled hypertension, compared to 27% of patients in the valsartan/amlodipine group. After 3 months, more patients had controlled blood pressure and blood pressure was lowered most in the perindopril/amlodipine group. 

The investigators concluded that giving a combination of perindopril and amlodipine and increasing the dose in a 3-step strategy was successful in reducing high blood pressure within 3 months.

Both drugs were increased in dose when a patient had not reached normal blood pressure levels; this means that the study did it compare a mixture of low and high doses of the different drugs which may be more effective or reduce the occurrence of side effects such as leg swelling caused by amlodipine. 

If you or someone you know has high blood pressure, talk to doctor about the different combinations of drugs that successfully reduce blood pressure.