Treatment of Hypertensive and Hypercholesterolaemic Patients with the Triple Fixed Combination of Atorvastatin, Perindopril and Amlodipine: The Results of the CORAL Study
Hypertension and hypercholesterolaemia are important contributors to the development and progression of atherosclerosis. The coexistence of these two conditions is rather common: hypercholesterolaemia is present in 40–60% of hypertensive patients. Remarkably, patient compliance with antihypertensive regimens is better than with statin therapy. Thus, the inclusion of statins and blood pressure-lowering agents into a fixed combination might even double the effectiveness of statin therapy, and thereby achieve significantly greater reduction of cardiovascular risk. The CORAL study was a 3-month, prospective, multicentre, observational, non-interventional survey, which evaluated the blood pressure- and lipid-lowering efficacy of the triple fixed combination of atorvastatin/perindopril/amlodipine, administered in various dose combinations.
The efficacy of the triple fixed combination was reflected by the changes of the blood pressure readings taken in the office and during 24-h blood pressure monitoring (3 months elapsed between visits 1 and 3). The laboratory parameters obtained during data acquisition were also recorded.
After 3 months of therapy, mean office blood pressure decreased from 158.5 ± 16.7/91.7 ± 9.4 to 132.2 ± 8.3/80.1 ± 6.8 mmHg (p < 0.0001), whereas mean 24-h blood pressure decreased from 146.0 ± 14.5/82.5 ± 12.1 to 132.1 ± 13.2/75.6 ± 9.9 mmHg. With regard to metabolic parameters, the inclusion of pre-existing statin therapy in the fixed combination led to further, significant reduction of lipid parameters as follows: total cholesterol level from 6.18 ± 1.15 to 5.16 ± 0.88 mmol/L, LDL-cholesterol from 3.41 ± 1.01 to 2.80 ± 0.82 mmol/L and triglyceride level from 2.26 ± 1.17 to 1.82 ± 0.83 mmol/L (all p < 0.0001).
Treatment with the fixed triple combination of atorvastatin, perindopril and amlodipine might take us closer to the optimal therapy for hypertensive patients with hypercholesterolaemia. The expected improvement of patient adherence to treatment may result in an increase of the percentage patients who achieve both blood pressure control and the LDL-cholesterol targets recommended in guidelines. Moreover, this may translate into the further decline of the risk of prospective cardiovascular events.
KeywordsACE inhibitor Adherence Calcium channel blocker Cardiology Fixed combination Hypercholesterolaemia Hypertension Statin
This study and the article processing charges for publication were funded by Egis Pharmaceuticals, Budapest, Hungary. All authors had full access to all of the data in this study and take complete responsibility for the integrity of the data and accuracy of the data analysis.
Medical Writing and/or Editorial Assistance
The authors acknowledge the contribution of all 729 participating primary care medical centers in Hungary. In addition to the other members of the CORAL investigator group, the authors would like to acknowledge the assistance of Norbert Habony MD (coordinator).
All named authors meet the International Committee of Medical Journal Editors (ICMJE) criteria for authorship for this manuscript, take responsibility for the integrity of the work as a whole, and have given final approval for the version to be published.
Attila Simon and Csaba András Dézsi have nothing to disclose.
Compliance with Ethics Guidelines
Patients received written and verbal information, and they signed a statement of consent. The research was designed in accordance with the valid regulations and the Declaration of Helsinki. Number of the study’s official approval (OGYÉI/51485-1/2016).
My manuscript has associated data in a data repository.
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