[PP.12.18] UPTITRATION TO FULL-DOSE PERINDOPRIL 10MG/INDAPAMIDE 2.5MG SINGLE-PILL COMBINATION IN HYPERTENSIVE DIABETIC PATIENTS WITH UNCONTROLLED BLOOD PRESSURE: PERFORMANCE STUDY SUBANALYSIS. (September 2017)

• Record Type: Journal Article
• Authors: Mourad, J.J.; Schueller, R.; Allaert, F.A.
• Is Part Of: Journal of hypertension. Volume 35(2017)Supplement 2
• Publication Date: 2017-09
• Subjects: Hypertension -- Periodicals; Hypertension -- Periodicals; 616.132005
• DOI: 10.1097/01.hjh.0000523528.15060.63
• Languages: English
• ISSNs: 1473-5598

Abstract

Abstract : Objective: To describe blood pressure (BP) control rates and metabolic profile after uptitrating to full-dose perindopril arginine 10 mg/indapamide 2.5 mg (PER/IND 10/2.5) single-pill combination in hypertensive patients with type 2 diabetes (T2D) that have uncontrolled blood pressure (BP) on lower-dose perindopril arginine/indapamide in the French PERFORMANCE study. Design and method: PERFORMANCE, a prospective observational study, included 542 doctors in France, enrolling 2746 hypertensive patients with T2D who had uncontrolled BP (>140/90 mmHg) on a RAAS inhibitor/diuretic combination (mean age 65 ± 10 years; 62% male). This subanalysis describes BP control rate in a subgroup of patients with uncontrolled BP on lower-dose PER/IND who were uptitrated to PER/IND 10/2.5 (n = 251). Adherence was assessed using a validated self-reported questionnaire. Mean follow-up: 35 days. Results: At baseline, BP was 156/90 mmHg and 38.6% of patients were obese (body mass index >30 kg/m 2 ). At day 35, BP control was 58.6%, but significantly greater in the group with good adherence vs poor adherence (64.3% vs 47.6%; P < 0.05), with 80.4% of patients self-reporting improvement in hypertension control with their new treatment and 93.2% of prescriptions renewed. Systolic/diastolic BP was reduced by 20.3 ± 10.3/11 ± 8.5 mm Hg (P < 0.0001 vs baseline). There was a significant improvement in HbA1c at day 35 (Delta −0.2%, P < 0.0001 vs baseline visit). Obesity had no significant impact on BP control. Conclusions: Uptitrating to PER/IND 10/2.5 in patients previously uncontrolled on lower-dose PER/IND allows rapid BP control in 59% of patients within 35 days, increasing to 64% in patients who are fully adherent to treatment, and is associated with significant improvement in HbA1c. This combination, containing 2.5 mg indapamide, was more effective than combinations containing high doses of hydrochlorothiazide, and could represent an alternative to adding a third agent. This rapid BP control was maintained even in difficult-to-treat obese patients, and was associated with high patient satisfaction and renewal of prescriptions.