Predictors of blood pressure response to intensified and fixed combination treatment of hypertension: The ACCOMPLISH Study

Kjeldsen, Sverre E.; Jamerson, Kenneth; Bakris, George L.; Pitt, Bertram; Dahlöf, Björn; Velázquez, Eric J.; Gupte, Jitendra; Staikos, Linda; Hua, Tsushung A.; Shi, Victor; Hester, Allen; Tuomilehto, Jaakko; Östergren, Jan; Ibsen, Hans; Weber, Michael A.

doi:10.1080/08037050801972857

Cited by 49 publications

(34 citation statements)

References 27 publications

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“…25,26 Control rates remained high (73% overall) and SBP/DBP remained low (132.7/74.7 mm Hg overall) at Month 12 and persisted throughout the study. 28 Adverse event rates were consistent with clinical experience with the individual agents, including a low incidence of hypotension (3% overall). 26 The results of ACCOMPLISH have applicability to the diabetic population given the notably high rate of baseline type 2 diabetes in this particular trial.…”

Section: But Are Target Bp Levels Attainable Within a Matter Of Months?supporting

confidence: 72%

“…25 Additional data are available for the diabetic subset, with BPo130/80 mm Hg documented in 36% of patients by Month 3 29 and in 43% at Month 12 (including 48% and 73% with SBP o130 mm Hg and DBPo80 mm Hg, respectively). 28 A multivariate analysis revealed that several patientspecific factors were significant for achieving BPo130/80 mm Hg in patients with diabetes, including lower baseline SBP, pretreatment with fewer antihypertensive agent classes, and history of coronary revascularization. 28 The prompt BP-lowering ability of fixed-dose dual combination antihypertensive therapy has also been demonstrated in an exclusively diabetic population, with 11 140 patients with type 2 diabetes having participated in the placebo-controlled Action in Diabetes and Vascular disease: preterAx and diamicroN-MR-Controlled Evaluation (ADVANCE) trial.…”

Section: But Are Target Bp Levels Attainable Within a Matter Of Months?mentioning

confidence: 99%

“…28 A multivariate analysis revealed that several patientspecific factors were significant for achieving BPo130/80 mm Hg in patients with diabetes, including lower baseline SBP, pretreatment with fewer antihypertensive agent classes, and history of coronary revascularization. 28 The prompt BP-lowering ability of fixed-dose dual combination antihypertensive therapy has also been demonstrated in an exclusively diabetic population, with 11 140 patients with type 2 diabetes having participated in the placebo-controlled Action in Diabetes and Vascular disease: preterAx and diamicroN-MR-Controlled Evaluation (ADVANCE) trial. 30 The fixed-dose ACEI/diuretic combination of perindopril/indapamide was significantly more effective than placebo with respect to the primary endpoint of preventing a macrovascular or microvascular event, as well as for the secondary endpoints of CV disease-related mortality and all-cause mortality.…”

Section: But Are Target Bp Levels Attainable Within a Matter Of Months?mentioning

confidence: 99%

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How early should blood pressure control be achieved for optimal cardiovascular outcomes?

et al. 2010

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As a consequence of the aging population and the increasing prevalence rates for conditions such as type 2 diabetes and chronic kidney disease (CKD), management of hypertension will be focusing more and more on the high-risk patient. Clinical practice guidelines for managing hypertension in the United States recommend a target blood pressure (BP) o130/80 mm Hg in patients with diabetes or CKD, notably lower than the 140/90-mm Hg threshold for the general hypertensive population. However, the optimal timeframe from initiation of antihypertensive therapy to attaining these levels of BP control and influencing cardiovascular outcomes is not as well defined. Overall, a series of landmark BP intervention trials in patients with hypertension and additional cardiovascular risk factors collectively support that achieving prompt BP control, ideally within 1-3 months, translates into improved cardiovascular outcomes. Although the consistency of the findings is encouraging, the strength of this conclusion is limited by the available data, which were derived from studies not designed to determine the definition or benefits of early BP reduction. In several of these studies, using a treatment approach with initial monotherapy or combination therapy has clearly demonstrated pronounced BP lowering and high BP control rates within an intensive timeframe of 3-6 months of therapy. Although these studies were not conducted exclusively in high-risk patients, subgroup analyses have demonstrated that the observed outcomes in the overall study populations apply to the diabetic and CKD subsets.

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Section: But Are Target Bp Levels Attainable Within a Matter Of Months?supporting

confidence: 72%

Section: But Are Target Bp Levels Attainable Within a Matter Of Months?mentioning

confidence: 99%

Section: But Are Target Bp Levels Attainable Within a Matter Of Months?mentioning

confidence: 99%

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How early should blood pressure control be achieved for optimal cardiovascular outcomes?

et al. 2010

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“…Так, результаты исследования ACCOМРLISH, где больные АГ переводились на фиксированную комбинацию (ИАПФ + диуретик или ИАПФ + антагонист кальция), показали улучшение контроля АД. В данном исследова-нии уже через 4 недели после назначения фиксирован-ной комбинации целевые уровни АД были достигнуты у 74% пациентов (против 37% в начале исследования) [1,2,4,6,7,9,10,12].…”

Section: клиника и фармакотерапияunclassified

Improvement of Amlodipine Control Efficacy Over Hypertension Using Fixed Combination of Perindopril Arginine and Amlodipine

Крючкова¹,

Ицкова²,

Лутай³

et al. 2015

Russ J Cardiol

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Цель. Оценка возможности повышения эффективности контроля артериаль-ной гипертензии при использовании фиксированной комбинации периндо-прила и амлодипина. Материал и методы. Обследовано 46 пациентов (25 мужчин и 21 женщина в возрасте 53,6±4,3 года) с артериальной гипертензией 2-3 степени. всем пациентам проводилось СмАд с анализом следующих параметров: средне-суточных показателей Ад, скорости утреннего подъема САд и дАд, а также вариабельность (вАР) ps Ад (вАР psАдд, вАР psАдн). Критериями включения в исследование были недостаточный контроль артери-альной гипертензии на фоне приема свободных комбинаций ингибитора АПФ или блокатора рецепторов ангиотензина II и диуретика или блокатора кальцие-вых каналов. для контроля артериальной гипертензии всем больным, включен-ным в исследование, использовалась фиксированная комбинация периндо-прила аргинин/амлодипин в стартовой дозе 10/5 мг (Престанс, Лабо ратории Сервье, Франция) c последующим возможным повышением дозы до 10/10 мг. Результаты. На фоне проводимой терапии у 84,7% пациентов было достиг-нуто "целевое" значение Ад. Среднесуточные значения САд уменьшились с 139,24±1,8 до 121,13±1,22 мм рт.ст. (р<0,05), дАд снизилось с 84,51±2,08 до 73,14±1,4 (р<0,05), Ад ср уменьшилось с 103,07±1,56 до 87,66±1,13 (р<0,05). Суточные значения вариабельности САд достоверно снизились с 15,28±0,72 до 10,21±0,42 (р<0,05), дАд с 13,46±0,72 до 10,72±0,31 (р<0,001). Показатели СУП после проведенного лечения также снизились. до лечения СУП САд составляла 27±3,26 мм рт.ст./ч, на фоне терапии -15,3±5,04 мм рт.ст./ч, (р<0,01); аналогично СУП дАд снизилась с 23,6±2,37 мм рт.ст./ч до 11±1,62 мм рт.ст., (р<0,01). Заключение. Применение фиксированной комбинации периндоприла арги-нина/амлодипина у больных с ранее неконтролируемой артериальной гипер-тензией на фоне свободных комбинаций антигипертензивных препаратов способствовало достижению целевых уровней Ад в 84,7% случаев. достигну-тый эффективный контроль Ад сопровождался, по данным СмАд, достовер-ным снижением средних показателей Ад в дневное и ночное время суток, вариабельности и скорости утреннего подъема Ад. Использование фиксиро-ванной комбинации периндоприла аргинина/амлодипина характеризовалось хорошей переносимостью и высокой приверженностью пациентов к лечению. Aim. To evaluate possibilities of hypertension control improvement using fixed combination of perindopril arginine and amlodipine. Material and methods. Totally 46 patients studied (25 men, 21 women of the age 53,6±4,3 y.) with arterial hypertension 2-3 grade. All patients underwent AbpM with analysis of the following: mean 24-hour bp, velocity of morning Sbp and Dbp rise, bp variability of ps bp (Vpsbpd, Vpsbpn). The criteria of inclusion were insufficient control over hypertension while using free combinations of ACE inhibitor or angiotensin II receptor blockers and diuretic or calcium channel blocker. To control arterial hypertension all patients were prescribed the fixed combination of perindopril arginine/amlodipine it standard dosage 10/5 mg (prestans, "Les Laboratories Ser...

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“…Hypertension Short Message Service is a new tool for disease management aimed at improving the success of the doctors daily routine in hypertension treatment both in terms of the quality of hypertension assessment and concerning the efficacy of treatment. At present there is a wide and disappointing difference between the results of treatment in routine work [1] and in clinical trials [2,3] even when the same cohort of patients is treated by the same therapists. The efficacy rate in daily routine is about 20-35% as compared to 70-85% during trials.…”

mentioning

confidence: 99%

Blutdrucksms

Magometschnigg¹,

Rothmayer²

2011

Wien Med Wochenschr

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Hypertension Short Message Service is a new tool for disease management aimed at improving the success of the doctor's daily routine in hypertension treatment both in terms of the quality of hypertension assessment and concerning the efficacy of treatment. At present there is a wide and disappointing difference between the results of treatment in routine work [1] and in clinical trials [2, 3] even when the same cohort of patients is treated by the same therapists. The efficacy rate in daily routine is about 20-35% as compared to 70-85% during trials. Assuming this gap is due to differences in disease management we integrated short message service and Internet applications into a new hypertension management tool (Blutdrucksms). According to our registry data "Blutdrucksms" is very successful: More than 80% of our hypertensive patients were treated to target. In June 2008, we implemented the SMS-Blood Pressure Protocol, and in October 2010, we analyzed the data of all "Blutdrucksms" users available in our registry. By then a total of 568 patients - 44% female and 56% male - had sent their self-recorded blood pressure readings as short messages to the SMS-Center; 75% of these patients had had at least one organ damage (left ventricular hypertrophy, increase in intima media thickening or carotid plaque). Mean casual blood pressure, recorded before enrolment into the SMS-program, was 152/83. It had improved to 136/80 mmHg by October 2010. The mean of the self-recorded blood pressures of the last month of participation was 128/76 mmHg and a heart rate of 69 beats per minute; 85% of all hypertensive patients had their pressures at treatment goal. Thus, we assume that "Blutdrucksms" is an excellent tool to improve the efficacy of antihypertensive disease management in routine work. We assume that the success is due to the enhanced communication between patient and doctor via SMS. As we are aware of the weakness of registry analysis we try to set up a controlled prospective study to compare "Blutdrucksms" users to non-users.

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Predictors of blood pressure response to intensified and fixed combination treatment of hypertension: The ACCOMPLISH Study

Cited by 49 publications

References 27 publications

How early should blood pressure control be achieved for optimal cardiovascular outcomes?

How early should blood pressure control be achieved for optimal cardiovascular outcomes?

Improvement of Amlodipine Control Efficacy Over Hypertension Using Fixed Combination of Perindopril Arginine and Amlodipine

Blutdrucksms

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