Clinical experience with perindopril, an angiotensin converting enzyme inhibitor (ACEI), in U.S. hypertensive patients - a large community-based trial

The effect of perindopril monotherapy on blood pressure (BP) reduction was investigated in 13,220 patients with mild to moderate hypertension in an open label, baseline-controlled 12-week community trial. Patients received perindopril 4 mg QD for 6 weeks and, based on the physician's assessment of BP response, 4 mg dose was maintained or increased to 8 mg QD for an additional 6 weeks. Seated BPs were measured at baseline, week 6 and week 12. Perindopril treatment for 12 weeks produced a clinically and statistically significant reduction from baseline in SBP and DBP. In addition, perindopril significantly attenuated pulse pressure in the elderly and in patients with isolated systolic hypertension (ISH). At week 12, BP normalization (<130/<85 mmHg) and BP control (<140/<90 mmHg) were achieved in 20% and 47%, respectively. BP reduction with perindopril was analyzed in the subgroups of elderly, African-American, ISH, diabetes, post stroke and other ACEI non-responders. (See Table) SBP/DBP (mmHg) values are expressed as mean ± SD for baseline and mean ± SEM for Δ Week 6 and Δ Week 12. All values are p < 0.01 from baseline. SBP/DBP (mmHg) values are expressed as mean ± SD for baseline and mean ± SEM for Δ Week 6 and Δ Week 12. All values are p < 0.01 from baseline. Adverse events were reported in 23% of the patients, of which cough and total angioedema were reported in 8% and 0.3%, respectively. Physicians assessed therapeutic response to perindopril as satisfactory in 79% of the patients at the end of study. These findings demonstrated that, in the general practice setting, perindopril monotherapy was effective and well tolerated in a large diverse US hypertensive population.