Perindopril and amlodipine – can this combination prevent organ damage in hypertension?

This study investigated the effects of the drug combination perindopril and amlodipine (PEAM) on organ damage in patients with hypertension with and without ischemic heart disease (IHD).

They found that PEAM was effective in reducing blood pressure and organ damage in these patients.

Hypertension or high blood pressure (BP) is a common condition. Hypertension can lead to heart disease, heart attacks, and stroke. If hypertension is not managed, high BP can also cause organ damage (OD). OD can also lead to the development of ischemic heart disease (IHD). IHD is caused by reduced blood flow to the heart.

Medications used to lower BP are called antihypertensive drugs (AHDs). By lowering BP, OD is reduced. Some AHDs can lead to greater reductions in OD. Perindopril and amlodipine are AHDs. It is unclear if PEAM combination can prevent OD. It is also unclear if the effects of PEAM on OD are different in patients with IHD versus those that do not.

This study included 60 patients with hypertension. Half of the patients in this study also had signs of IHD. All patients were given a fixed dose of PEAM (5 mg perindopril and 5 mg amlodipine). This was increased up to 10 mg/10 mg if required. Patients that reached a BP target of less than 140/90 mmHg by 6 months were included in the analysis. If this target BP was not achieved by 6 weeks with the maximum PEAM dose, a diuretic (indapamide; an AHD that increases the amount of water expelled by the body through urine) was added. BP was measured using a number of methods. Organ damage was assessed using echocardiograms (ultrasound of the heart) and blood analysis.

All patients achieved the BP target by 6 months. Patients with IHD had greater reductions in BP after 1-3 months of treatment. Patients with IHD had more stable 24-hour BP readings than non-IHD patients. Indapamide was needed less frequently in patients with IHD (23.3%) than in those without IHD (60%).

Organ damage improved in all patients. The stiffness of the arteries and function of the heart improved in both IHD and non-IHD patients. Protein levels in the urine (albuminuria) was reduced, improving kidney function. Overall, 5 patients experienced side effects to PEAM treatment. There were no serious adverse events.

The authors concluded that PEAM combination reduced blood pressure and organ damage in patients with hypertension with and without IHD.

The number of patients in this study was small. All patients were treated with PEAM so we do not know if other medications may also prevent OD.

If you have any concerns regarding hypertension and heart disease, please consult with your physician.