ŠPINAR, Jindřich, Lenka ŠPINAROVÁ and Jiří VÍTOVEC. Studie PIANIST - trojkombinace v léčbě hypertenze (The PIANIST Study – Triple Combination in the Treatment of Hypertension). Hypertenze & kardiovaskulární prevence. Praha: Target MD, 2015, vol. 4, No 1, p. 20-23. ISSN 1805-4129.
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Basic information
Original name Studie PIANIST - trojkombinace v léčbě hypertenze
Name (in English) The PIANIST Study – Triple Combination in the Treatment of Hypertension
Authors ŠPINAR, Jindřich (203 Czech Republic, guarantor, belonging to the institution), Lenka ŠPINAROVÁ (203 Czech Republic, belonging to the institution) and Jiří VÍTOVEC (203 Czech Republic, belonging to the institution).
Edition Hypertenze & kardiovaskulární prevence, Praha, Target MD, 2015, 1805-4129.
Other information
Original language Czech
Type of outcome Article in a journal
Field of Study 30201 Cardiac and Cardiovascular systems
Country of publisher Czech Republic
Confidentiality degree is not subject to a state or trade secret
RIV identification code RIV/00216224:14110/15:00083428
Organization unit Faculty of Medicine
Keywords (in Czech) hypertenze; trojkombinace; Pianist; fixní kombinace
Keywords in English hypertension; triple therapy; fixed combination
Tags EL OK
Changed by Changed by: Ing. Mgr. Věra Pospíšilíková, učo 9005. Changed: 24/7/2015 12:19.
Abstract
Podáváme přehled současných názorů na kombinační léčbu a na postavení fixních kombinací v léčbě hypertenze podle doporučení ESH/ESC a ČSH z roku 2013. Mezi nejčastěji doporučované dvojkombinace patří blokátor renin angiotenzinového systému (ACE-I nebo sartan) a blokátor vápníku, dále blokátor renin-angiotenzinového systému a diuretikum a blokátor vápníku a diuretikum. V roce 2014 se na českém trhu objevila fixní kombinace ACE inhibitor (perindopril), blokátor vápníku (amlodipin) a diuretikum (indapamid). Trojkombinaci k dobré kontrole tlaku potřebuje asi 1/3 hypertonikú. Ve studii the PIANIST u 4 731 nedostatečně kontrolovaných hypertoniků trojkombinace perindopril, amlodipin a indapamid vedla ke snížení krevního tlaku o 28,3/13,8 mm Hg a k dostatečné kontrole hypertenze u 92 % nemocných. Výhoda fixních kombinací je především ve větší compliance nemocného a tím v lepší kontrole hypertenze.
Abstract (in English)
The objective of the PIANIST study was to evaluate a triple-drug antihyper-tensive strategy for blood pressure control in patients with difficult-to-treat hypertension. The Perindopril-Indapamide plus AmlodipiNe in high rISk hy-perTensive patients (PIANIST) trial was an observational, 4-month, open-label study. A total of 4,731 patients at high or very high cardiovascular risk with hypertension that was not properly controlled despite antihypertensive thera-py, and for whom study treatment (fixed-dose perindopril 10 mg/indapamide 2.5 mg, amlodipine 5 or 10 mg) was consistent with their existing therapeutic plan, were included. Results: Mean baseline office blood pressure (OBP) was 160.5 +/- 13.3/93.8 +/- 8.7 mmHg. After 4 months of therapy, OBP decreased by 28.3 +/- 13.5/13.8 +/- 9.4 to 132.2 +/- 8.6/80.0 +/- 6.6 mmHg (p\0.0001). Blood pressu-re targets were reached by 72.0 %of patients and by 81 and 91 % of patients previously treated with an angiotensinconverting enzyme inhibi-tor/hydrochlorothiazide or an angiotensin receptor blocker/hydrochlorothiazide, respectively. Ankle edema was infrequent (0.2 % of patients). Conclusion Triple combination perindopril/indapamide/amlodipine was effectively and safely administered to a large population of high- and very high-risk hypertensive patients who had not reached target OBP values with previous treatment.
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