PROSPECTIVE, NON-INTERVENTIONAL, OBSERVATIONAL STUDY ASSESSING THE EFFECTIVENESS OF PERINDOPRIL AND PERINDOPRIL/INDAPAMIDE IN A BANGLADESHI POPULATION OF PATIENTS WITH HYPERTENSION

ABSTRACT

Background: In Bangladesh, it has been reported that the age-standardized prevalence of hypertension is 24.4%. The joint BHS/NICE 2011 guidelines for the treatment of hypertension were updated and now recommend that in newly diagnosed patients under 55 years of age, an ACE inhibitor can be used as the first-line treatment. Most recent guidelines for managing arterial hypertension state the combination of ACE inhibitors and thiazide diuretics as preferred combinations when considering two-drug treatment.

Objective: To evaluate the effectiveness and tolerability of perindopril and a fixed combination of perindopril/indapamide (4mg/1.25mg) in newly diagnosed and uncontrolled Bangladeshi hypertensive patients with or without diabetes.

Study design: The FIRST trial was a prospective, non-interventional, observational, outpatient study involving 76 general practitioners/primary care physicians in 7 divisions of Bangladesh.

Patients: Adults aged 40–65 years with newly diagnosed stage-I hypertension (BP ≥140/90 mmHg), newly diagnosed stage-II hypertension (BP ≥160/100 mmHg), or uncontrolled with previous antihypertensive treatment (monotherapy or combined therapy).

Results: In total, 2173 patients comprised the ITT population: 39.2. % with newly diagnosed stage- I hypertension; newly diagnosed stage-II hypertension 21.7% and uncontrolled with previous antihypertensive treatment 39.1%. Mean SBP/DBP decreased significantly (-29.29±15.35/- 13.38±8.83 mmHg; p < 0.001) from baseline (158.91±15.76/94.91 ± 9.08 mmHg) over 90 days. BP reduction was also significant in subgroup analysis: in group-I patients (n=751) receiving perindopril 4mg (-22.59±11.26/-11.11 ± 7.02 mmHg; p<0.001) and in group-II patients (n=996) receiving fixed combination of perindopril/indapamide (-34.50 ± 15.66/-14.92 ± 9.20 mmHg; p< 0.001). Treatment with perindopril and a fixed combination of perindopril/indapamide was safe and well-tolerated.

Conclusion: Perindopril and fixed combination of perindopril/indapamide were found to be effective and well tolerated antihypertensive treatments in the management of hypertension in Bangladeshi population.

Keywords: PERINDOPRIL, HYPERTENSION