Fixed triple combination of amlodipine, perindopril and atorvastatin in the focus of cardiovascular effectiveness and safety
https://doi.org/10.38109/2225-1685-2023-3-76-80
Abstract
The review outlines modern concepts of the relevance of fixed-dose combination therapy comprising angiotensin-converting enzyme inhibitor and dihydropyridine calcium channel antagonist as an antihypertensive component with the HMG-CoA reductase inhibitor when treating hypertensive patients. We have identified the realms of its possible clinical use taking into consideration the comorbidity peculiarities. In addition, we provide main features of the current drugs’ clinical pharmacodynamics and outline their role in real clinical practice. Nevertheless the emphasis was placed on the modern single-pill combination of amlodipin, atorvastatin and perindopril. We concisely report the results data collected from the large, randomized, double-blind major clinical trials regarding the effectiveness of single pill combination of amlodipine, atorvastatin and perindopril , primary focusing on their cardioprotective features and overall safety profile.
About the Authors
A. N. KuchminRussian Federation
Alexey N. Kuchmin - Dr. of Sci. (Med.), Head and Professor Department of propedeutics of internal diseases, S.M. Kirov Military Medical Academy.
6 Akademika Lebedeva str., Saint Petersburg
T. S. Sveklina
Russian Federation
Tatyana S. Sveklina - Cand. of Sci. (Med.), Associate Professor of the Internal diseases propadeutics, S.M. Kirov Military Medical Academy.
Suvorovskyi pr., 63 a, Saint Petersburg 191124
P. D. Oktysyuk
Russian Federation
Polina D. Oktysyuk - 5th year student, S.M. Kirov Military Medical Academy.
6 Akademika Lebedeva str., Saint Petersburg 194044
A. I. Rechkalova
Russian Federation
Alina I. Rechkalova - 5th year student, S.M. Kirov Military Medical Academy.
6 Akademika Lebedeva str., Saint Petersburg 194044
V. V. Konyaev
Russian Federation
Vladislav V. Konyaev - 5th year student, S.M. Kirov Military Medical Academy.
6 Akademika Lebedeva str., Saint Petersburg 194044
References
1. Kashtalap V.V. Therapy for hypertension and dyslipidemia: potential of Lipertans (on the example of a clinical observation). Russian Journal of Cardiology. 2022;27(11):5285 (In Russ.). https://doi.org/10.15829/1560-4071-2022-5285
2. Kobalava Z.D., Konradi A.O., Nedogoda S.V. et al. Arterial hypertension in adults. Clinical guidelines 2020. Russian Journal of Cardiology. 2020;25(3):3786. (In Russ.). https://doi.org/10.15829/1560-4071-2020-3-3786
3. Syed Y.Y. Perindopril/Indapamide/Amlodipine in Hypertension: A Profile of Its Use. Am J Cardiovasc Drugs. 2022;22(2):219-230. https://doi.org/10.1007/s40256-022-00521-0
4. Leonova M.V. Clinical pharmacology of the combination of ACE inhibitors and calcium antagonists: benefits of the perindopril arginine and amlodipine combination. Cardiovascular Therapy and Prevention. 2010;9(8):55-62 (In Russ.).
5. Sever P.S., Poulter N.R., Elliott W.J. et al. Blood pressure reduction is not the only determinant of outcome. Circulation. 2006;113(23):2754-2774. https://doi.org/10.1161/CIRCULATIONAHA.105.588020
6. Aronov D.M. The role of amlodipine (norvasc) in Cardiology. CardioSomatics. 2014;5(2):15-23 (In Russ.). https://doi.org/10.26442/CS45075
7. Hoff P.T., Tamura Y., Lucchesi B.R. Cardioprotective effects of amlodipine in the ischemic-reperfused heart. Am J Cardiol. 1989;64(17):101I-116I. https://doi.org/10.1016/0002-9149(89)90967-3
8. Ostroumova O.D., Guseva T.F., Bondarets O.V. Experience of using a fixed-dose combination of perindopril and amlodipine in the clinical practice settings: a real-world opportunity to increase antihypertensive therapy effectiveness. Russian Journal of Cardiology. 2013;(5):44-49 (In Russ.). https://doi.org/10.15829/1560-4071-2013-5-44-49
9. Mach F., Baigent C., Catapano A.L. et al. 2019 ESC/EAS Guidelines for the management of dyslipidaemias: lipid modification to reduce cardiovascular risk. Eur Heart J. 2020;41(1):111-188. https://doi.org/10.1093/eurheartj/ehz455
10. Morofuji Y., Nakagawa S., Ujifuku K. et al. Beyond Lipid-Lowering: Effects of Statins on Cardiovascular and Cerebrovascular Diseases and Cancer. Pharmaceuticals (Basel). 2022;15(2):151. https://doi.org/10.3390/ph15020151
11. Luan Z., Chase A.J., Newby A.C. Statins inhibit secretion of metalloproteinases-1, -2, -3, and -9 from vascular smooth muscle cells and macrophages. Arterioscler Thromb Vasc Biol. 2003;23(5):769-775. https://doi.org/10.1161/01.ATV.0000068646.76823.AE
12. Sever P.S., Dahlöf B., Poulter N.R. et al. Prevention of coronary and stroke events with atorvastatin in hypertensive patients who have average or lower-than-average cholesterol concentrations, in the Anglo-Scandinavian Cardiac Outcomes Trial-Lipid Lowering Arm (ASCOT-LLA): a multicentre randomised controlled trial. Lancet. 2003;361(9364):1149-1158. https://doi.org/10.1016/S0140-6736(03)12948-0
13. Schwartz G.G., Olsson A.G., Ezekowitz M.D. et al. Effects of atorvastatin on early recurrent ischemic events in acute coronary syndromes: the MIRACL study: a randomized controlled trial. JAMA. 2001;285(13):1711-1718. https://doi.org/10.1001/jama.285.13.1711
14. Okazaki S., Yokoyama T., Miyauchi K. et al. Early statin treatment in patients with acute coronary syndrome: demonstration of the beneficial effect on atherosclerotic lesions by serial volumetric intravascular ultrasound analysis during half a year after coronary event: the ESTABLISH Study. Circulation. 2004;110(9):1061-8. https://doi.org/10.1161/01.CIR.0000140261.58966.A4
15. Newman C.B., Palmer G., Silbershatz H., Szarek M. Safety of atorvastatin derived from analysis of 44 completed trials in 9,416 patients. Am J Cardiol. 2003;92(6):670-676. https://doi.org/10.1016/S0002-9149(03)00820-8
16. Fiorentino R., Chiarelli F. Statins in Children, an Update. Int J Mol Sci. 2023;24(2):1366. https://doi.org/10.3390/ijms24021366
17. Ferrari F., Martins V.M., Rocha V.Z., Santos R.D. Advances with lipid-lowering drugs for pediatric patients with familial hypercholesterolemia. Expert Opin Pharmacother. 2021;22(4):483-495. https://doi.org/10.1080/14656566.2020.1832991
18. Ivanovic B., Tadic M. Fixed combination of amlodipine/atorvastatin: from mechanisms to trials. J Cardiovasc Pharmacol Ther. 2013;18(6):544-549. https://doi.org/10.1177/1074248413492907
19. Erdine S., Ro Y.M., Tse H.F. et al. Single-pill amlodipine/atorvastatin helps patients of diverse ethnicity attain recommended goals for blood pressure and lipids (the Gemini-AALA study). J Hum Hypertens. 2009;23(3):196-210. https://doi.org/10.1038/jhh.2008.114
20. Ference B.A., Bhatt D.L., Catapano A.L. et al. Association of Genetic Variants Related to Combined Exposure to Lower Low-Density Lipoproteins and Lower Systolic Blood Pressure With Lifetime Risk of Cardiovascular Disease. JAMA. 2019;322(14):1381-1391. https://doi.org/10.1001/jama.2019.14120
21. Messerli F.H., Bakris G.L., Ferrera D. et al. Efficacy and safety of coadministered amlodipine and atorvastatin in patients with hypertension and dyslipidemia: results of the AVALON trial. J Clin Hypertens (Greenwich). 2006;8(8):571-583. https://doi.org/10.1111/j.1524-6175.2006.05636.x
22. Dalal J.J., Padmanabhan T.N., Jain P. et al. LIPITENSION: Interplay between dyslipidemia and hypertension. Indian J Endocrinol Metab. 2012;16(2):240-245. https://doi.org/10.4103/2230-8210.93742
23. Oktysyuk P.D., Sveklina T.S. Application of non-invasive assessment of brachial artery’s flow-mediated vasodilationas an early atherosclerosis predictor in patients with various cardiovascular risk-factors. Itogovaya konferentsiya voenno-nauchnogo obschestva kursantov, studentov i slushateley Voenno-meditsinskoy akademii imeni S.M. Kirova: Materialyi itogovoy konferentsii. 2023:438-446 (In Russ.).
Review
For citations:
Kuchmin A.N., Sveklina T.S., Oktysyuk P.D., Rechkalova A.I., Konyaev V.V. Fixed triple combination of amlodipine, perindopril and atorvastatin in the focus of cardiovascular effectiveness and safety. Eurasian heart journal. 2023;(3):76-80. (In Russ.) https://doi.org/10.38109/2225-1685-2023-3-76-80