Perindopril: first-line treatment for hypertension

Area of Science:

• Cardiology
• Pharmacology
• Clinical Trials

Background:

• Essential hypertension is a prevalent cardiovascular condition requiring effective management.
• Several classes of antihypertensive medications exist, including ACE inhibitors, beta-blockers, and diuretics.
• Comparing the efficacy and tolerability of different antihypertensive agents is crucial for optimizing patient care.

Purpose of the Study:

• To evaluate the antihypertensive efficacy of perindopril compared to captopril, atenolol, and a hydrochlorothiazide + amiloride diuretic.
• To assess the acceptability and tolerability of perindopril in patients with essential hypertension.

Main Methods:

• Three double-blind, parallel, multicenter studies were conducted.
• 165-173 patients with essential hypertension were randomized to perindopril (4 mg once daily) or captopril, atenolol, or a diuretic combination.
• Treatment was adjusted over 3 months to achieve a supine diastolic blood pressure (DBP) ≤ 90 mmHg.

Main Results:

• Perindopril achieved higher overall blood pressure control rates compared to captopril (75% vs 57%) and atenolol (78% vs 58%).
• Perindopril showed comparable efficacy to the diuretic combination (78% vs 84%).
• The dropout rate due to side effects was similar across all treatment groups, with perindopril demonstrating good biological acceptability.

Conclusions:

• Perindopril is an effective and well-tolerated antihypertensive medication.
• Perindopril offers significant advantages in blood pressure control over captopril and atenolol.
• Perindopril represents a valuable therapeutic option for managing essential hypertension.