PMID- 32515706
OWN - NLM
STAT- MEDLINE
DCOM- 20200805
LR  - 20200805
IS  - 0022-9040 (Print)
IS  - 0022-9040 (Linking)
VI  - 60
IP  - 5
DP  - 2020 Jun 3
TI  - [Therapeutic approaches to the Rational Use of trip-le combination therapy with a 
      fixed combination of amlodipine, indapamide and perindopril arginine (TRIPLE 
      COMBINATION) in patients with hypertension who do not control blood pressure on 
      conventional treatment. (Description and main results of the TRIO program)].
PG  - 1149
LID - 10.18087/cardio.2020.5.n1149 [doi]
AB  - Aim To study tactics of outpatient physicians in choosing the treatment when the 
      previous double antihypertensive therapy (AHT) fails and to analyze the 
      effectivity of an amlodipine/indapamide/perindopril arginine triple combination 
      (TC).Material and methods The program included 1252 patients with arterial 
      hypertension (AH); the TC group consisted of 992 (79.23 %) patients (38.3 % 
      males; age, 61.6 [55.0; 67.9]); the control group included 260 (20.77 %) patients 
      (37.7 % males; age, 60.6 [53.3; 67.4]). The main inclusion criteria were 
      essential AH, age 18-79 years, insufficient response to previous AHT (clinical 
      systolic blood pressure (SBP) >140-179 mm Hg). The study duration was three 
      months. The following parameters were evaluated: dynamics of clinical and 
      ambulatory BP (BP self-monitoring (BPSM); frequency of achieving the first goal 
      of <140 / 90 mm Hg and the goal of <130 / 80 mm Hg); and changes in 
      glomerular filtration rate (GFR) and quality of life (QoL). Responses to TC were 
      analyzed in groups with different ranges of increased baseline SBP in patients 
      with AH and diabetes mellitus (DM)/impaired glucose tolerance (IGT), overweight 
      or obesity, and chronic kidney disease (CKD, reduced estimated GFR (eGFR 
      <60 ml/min/1.73 m2). Safety was evaluated based on records of adverse events 
      (AEs).Results The TC group had a more severe condition at baseline by clinical 
      parameters and history and had higher baseline BP, which made difficult the 
      intergroup comparison. Nevertheless at three months, the decrease in clinical SBP 
      was more pronounced in the TC group (from 162.1  to 126.8 mm Hg, Delta=35.7  mm Hg) 
      than in the control group (from 157.8 to 128.4  mm Hg, Delta=29.4  mm Hg). 87.8% of 
      patients in the TC group and 81.9 % (small er, Cyrillic=0.012) in the control group achieved the 
      first BP goal of <140 / 90 mm Hg; 34.3% and 28.2% of patients, respectively, 
      achieved the BP goal of <130 / 80 mm Hg (small er, Cyrillic=0.055). The more effective SBP 
      control in the TC group was associated with a pronounced BP decrease with higher 
      BP values at baseline, which was also confirmed by an analysis in subgroups with 
      SBP 140-160, 160-180, and >180 mm Hg. The TC treatment was associated with a 
      pronounced antihypertensive effect with respect of BPSM values, improved QoL, and 
      renal function. Significant decreases in BP and achievement of BP goals by a vast 
      majority of patients receiving TC were also observed in subgroups with DM or IGT, 
      overweight and/or obesity, and CKD. AEs were observed during the treatment only 
      in 8 patients (0.64 %), which confirmed good tolerability and high safety of the 
      therapy.Conclusion The study results demonstrated a therapeutic effect of the 
      amlodipine/indapamide/perindopril arginine fixed-dose combination (Triplixam(R)). 
      This effect was evident as control of clinical BP with any baseline BP level, 
      including different ranges of increased SBP, in AH combined with DM, IGT, 
      obesity, and CKD, which offers advantages over a subjective choice of AHT. TC 
      improved BPSM values, QoL indexes, provided nephroprotection, and was well 
      tolerated.
FAU - Mareev, V Yu
AU  - Mareev VY
AD  - Medical Research and Educational Center of the M. V. Lomonosov Moscow State 
      University, Moscow, Russia.
FAU - Minina, Yu V
AU  - Minina YV
AD  - Society of Experts in Heart Failure, Ltd, Moscow, Russia.
FAU - Begrambekova, Yu L
AU  - Begrambekova YL
AD  - Medical Research and Educational Center of the M. V. Lomonosov Moscow State 
      University, Moscow, Russia.
FAU - Levin, A M
AU  - Levin AM
LA  - rus
PT  - Journal Article
DEP - 20200603
PL  - Russia (Federation)
TA  - Kardiologiia
JT  - Kardiologiia
JID - 0376351
RN  - 0 (Antihypertensive Agents)
RN  - 0 (Drug Combinations)
RN  - 1J444QC288 (Amlodipine)
RN  - 94ZLA3W45F (Arginine)
RN  - F089I0511L (Indapamide)
RN  - Y5GMK36KGY (Perindopril)
SB  - IM
MH  - Aged
MH  - Amlodipine
MH  - Antihypertensive Agents
MH  - Arginine
MH  - Blood Pressure
MH  - Blood Pressure Monitoring, Ambulatory
MH  - Drug Combinations
MH  - Female
MH  - Humans
MH  - *Hypertension
MH  - Indapamide
MH  - Male
MH  - Middle Aged
MH  - Perindopril
MH  - Quality of Life
MH  - Treatment Outcome
EDAT- 2020/06/10 06:00
MHDA- 2020/08/06 06:00
CRDT- 2020/06/10 06:00
PHST- 2020/04/24 00:00 [received]
PHST- 2020/05/03 00:00 [accepted]
PHST- 2020/06/10 06:00 [entrez]
PHST- 2020/06/10 06:00 [pubmed]
PHST- 2020/08/06 06:00 [medline]
AID - 10.18087/cardio.2020.5.n1149 [doi]
PST - epublish
SO  - Kardiologiia. 2020 Jun 3;60(5):1149. doi: 10.18087/cardio.2020.5.n1149.