M.I. Lutai, A.F. Lysenko on behalf of the TRIUMF-2 multicenter study group Treatment of arterial hypertension with a fixed combination of ACE inhibitor, calcium channel blocker and thiazide-type diuretic. The results of the Ukrainian multicenter study ТРІУМФ-2

The aim – to study the profile of patients with uncontrolled arterial hypertension receiving simultaneously 2 or 3 antihypertensive agents, and to evaluate blood pressure control in this population after change of the treatment.

Material and methods. The multicenter open-label observational study ТРІУМФ-2 was conducted in Ukraine since November 2016 to April 2017. The study covered 3,556 patients with AH who were prescribed 2 or 3 antihypertensive drugs without sufficient effect for at least 1 month (2.4 years on average). The average values of office BP of the population in the study were 173/100 mm Hg. Almost half of the patients (48.1 %) had systolic (SBP) and / or diastolic (DBP) BP ≥ 180/110 mm Hg. For further treatment prescription of fixed combination of angiotensin-converting enzyme inhibitor (IACE), dihydropyridine calcium channel blocker (CCB) and diuretic, and if necessary, other agents and medical supervision for 3 months were proposed. The chosen drug for 3,555 patients was the original triple fixed combination of perindopril arginine, indapamide and amlodipine. The patients visited their doctors after 1 and 2 weeks, 2 and 3 months. Adherence to the treatment was assessed before and after 2 months of treatment. Furthermore, 64 % of the participants of the ТРІУМФ-2 filled in the BP control diaries.

Results. The prescription of the original triple fixed combination for 3 months was accompanied by the decrease of office BP to the target levels (<140/90 mm Hg) in 79 % of cases. The maximum dynamics of BP values was observed during the first week after the initiation of the therapy: the average changes in the parameters from the baseline were 30 mm Hg for SBP (P<0.001), and 13 mm Hg for DBP (P<0.001). This fact reflects rapid and effective action of this drug. By the end of the observation, the mean values of BP of the study population were 129/78 mm Hg. The patients who received and returned the BP control diary (97.67 %), showed significantly higher level of adherence to the treatment in comparison with the participants who did not fill in the diaries (75.83 %). Original triple combination of perindopril arginine / indapamide / amlodipine was characterized not only by the convenience of medication administration, but also by good tolerability. Conclusions. Original triple combination of perindopril arginine / indapamide / amlodipine in average daily doses of 8.48 / 2.12 / 7.34 mg provides most significant decrease of office BP after 7 days: average SBP – 30 mm Hg (17 %) and DBP – by 13 mm Hg (13 %) with further slow decrease of BP during next 2 weeks and 2–3 months of the study among patients who took 2-3 antihypertensive drugs. Usage of the original fixed combination in patients with baseline mean BP 173/100 mm Hg for 7 days provided effective BP control in 28 % patients, after 2 weeks – in 41 %, in 2–3 months – in 71–79 % patients, regardless of the previous therapy and initial degree of BP increase.

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