Accomplish is the first study that compares results of fixed-dose combinations of an inhibitor of the renin angiotensin system (RAS) to reduce the episodes cardiovasculares1
The combination of a RAS inhibitor with amlodipine reduced by 20% the risk of cardiovascular events in high risk patients, compared with the combination of an inhibitor of the RAS with diurético1
The results accomplished, published in New England Journal of Medicine, show that with fixed-dose combinations, approximately twice of patients achieved the target blood pressure than with previous monotherapy or politerapias1
Patients treated with each of the fixed-dose combinations achieved a mean systolic blood pressure of 130 mmHg1
Accomplish the final results of the first study comparing fixed-dose combinations of antihypertensive drugs in reducing cardiovascular events (CV) have shown that an inhibitor of the renin-angiotensin system (RAS), benazepril combined with amlodipine reduced BESILATE BESYLATE of 20 % CV events such as myocardial infarction and stroke in hypertensive patients at high risk, compared with a combination of RAS inhibitor with hydrochlorothiazide (HCT) 1
The results of accomplish (Avoiding Cardiovascular Events through Combination Therapy in Patients Living With systolic Hypertension; Avoiding cardiovascular events with combination therapy in patients with systolic hypertension), published today in The New England Journal of Medicine, show that some patients were able to double the target blood pressure with a fixed-dose combination compared with their previous antihypertensive treatment, irrespective of whether they were alone or politerapia.1
At the start of the study, only 37% of patients met the target of systolic pressure <140 mmHg.1 After switching to a fixed-dose combination, 72% (combination with HCT) and 75% (combination with amlodipine) of patients achieved the target blood pressure at the end of the trial, with a mean value of systolic pressure of 130 mmHg.1
It is the first study results in a large scale and achieves a value of pressure sistólica.1 systolic blood pressure is a measure of the maximum force exerted against the heart beats when the glasses. This result is very significant because the systolic pressure increases with age and is an important indicator of the risk that a person present episodes CV.2 Indeed, hypertension (HTA) is one of the most important risk factors, but treatable of CV disease (the leading cause of death worldwide) 3
Experience says Barrios, a cardiologist at the Hospital Ramón y Cajal de Madrid, accomplish results open interesting new perspectives on the utility of using fixed combinations in the initial treatment of hypertension in high risk patients, unlike the monotherapy, which is what usually does. "
The cardiologist noted that Barrios Experience the study reached an excellent level in controlling the numbers of blood pressure in more than 72% of patients at high risk. "
Examples of inhibitors of the SRA are receptor antagonists of angiotensin (ARA-II, such as valsartan (Diovan ®) and inhibitors of angiotensin converting enzyme (ACE inhibitors such as benazepril). It has been observed that through inhibition of RAS with a single O-II or an ACE inhibitor reduces episodes CV.4-7 However, more than half of hypertensive patients may need polytherapy to achieve the goals of pressure arterial.8
Patients may have greater compliance, if they take their medication in a single tablet that when there are two different tablets, 9 but so far there had been no test results that support the early use of fixed-dose combinations in the course treatment. On accomplished, half the patients achieved their goal of taking blood pressure medication in a single tablet, ie without any treatment adicional.10 addition, approximately 70% of patients taking the combination at the end of estudio.1
The two fixed-dose combinations were well tolerated. The incidence of adverse events that led to the withdrawal of the study was low, approximately 15% of both groups and only 0.5% (combination with HCT) and 0.4% (combination with amlodipine) experienced adverse events such as hypotension grave.1
"For patients with hypertension who need simple and effective therapeutic strategies to help reduce the risk of CV events, the results indicate that accomplish a fixed-dose combination of an RAS inhibitor and amlodipine is an effective option, well tolerated and convenient, "said Dr. Ameet Nathwani, director of international franchise development and Cardiovascular Metabolism Novartis Pharma AG.
Novartis' confidence in the strategy of fixed-dose combination is reflected in the success of two of its antihypertensive: Exforge ®, the first fixed combination of valsartan and amlodipine and Co-Diovan ® (Diovan plus hydrochlorothiazide). Both Exforge ® as Co-Diovan ® has been recently approved in USA for first-line use in patients likely to require polytherapy to achieve their goal blood pressure. Exforge ® is a new combination therapy (valsartan and amlodipine), which gives patients the opportunity to better control your blood pressure and allows for greater tolerability and adherence to treatment. In Spain, Exforge ® is indicated in patients whose blood pressure is not adequately controlled with amlodipine or valsartan monotherapy, while Co-Diovan ® is indicated in patients whose blood pressure is not adequately controlled with valsartan monotherapy.
Novartis is dedicated to improving the lives of hundreds of millions of people with CV and metabolic diseases through medicines and effective programs, and its continued commitment to research. As a global leader in CV and metabolic health for nearly 50 years, Novartis provides innovative therapies and support programs to treat hypertension and diabetes, two major public health problems.
The product portfolio Novartis is focused on drugs for cardiovascular disease, specifically for the treatment of hypertension and diabetes: Exforge ®, and Co-Diovan ® and Diovan ® Rasilez ® (aliskiren) the first and only direct inhibitor renin and authorized a new DPP-4 inhibitor Galvus ® (vildagliptin, which is also available as a fixed dose combination with metformin, Eucreas ®).
About accomplish
Accomplish is a test based on events, multicenter, multinational, randomized, double blind, which has involved more than 11,000 patients from 550 centers around the U.S. and Scandinavian countries. The evaluation criteria included composite of myocardial infarction, stroke, hospitalizations for unstable angina pectoris and CV death in hypertensive patients at high risk. This is the first test results in a CV hypertensive population, in which all patients were randomized to receive a fixed-dose combination therapy at the beginning of the test rather than a therapeutic staggered pattern. Patients received a fixed dose combination of an RAS inhibitor (benazepril) with BESILATE BESYLATE of amlodipine or same RAS inhibitor with HCT. In the first 2 months of the study, increased doses of drugs for study: the inhibitor of the renin-angiotensin system was increased gradually to 40 mg and subsequently in patients who did not achieve the target blood pressure was increased gradually HCT 25 mg and amlodipine 10 mg.
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