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Objective: Objectives. To evaluate the effectiveness of perindopril arginine/ amlodipine single-pill combination (SPC) in patients with grade 1–2 hypertension uncontrolled on previous therapy with ARB-containing free combinations. Design and method: AVANGARD was a multicenter, open-label, 3-month Russian observational study, in 658 patients with suboptimal efficacy (SBP/DBP 140–179/90–109 mm Hg) of previous antihypertensive therapy with two drugs in free combination (one of which was an ARB), who were switched to perindopril arginine/amlodipine SPC. Data were collected at four visits: V1 (inclusion visit and treatment initiation), V2 (2 weeks), V3 (1 month), V4 (3 months). Results: The SBP/DBP values gradually and significantly decreased with Perindopril/amlodipine SPC from 159.9 ± 8.5/ 92.1 ± 7.4 mmHg to 141.3 ± 11.0/83.7 ± 7.5 mmHg after 2 weeks, 131.7 ± 9.2/79.5 ± 6.0 mmHg after 1 month and finally 125.8 ± 7.1 /77.4 ± 5.5 mm Hg; all p < 0.001). The controlled BP was achieved in 36.2%, 73.4 and 93.5% of patients at V2, V3 and V4, respectively. The mean HR followed the same patern (V1: 73.9 ± 7.3 beats per minute (bpm); V4: 68.9 ± 5.0 bpm; p < 0.001). Daytime 24-hour BP variability decreased from V2 to V4, from 4.4 ± 2.9/3.0 ± 2.0 to 3.0 ± 2.2/2.2 ± 1.7 mm Hg (p < 0.001). Treatment acceptability was very high considering couple related adverse events (0,21%) in accordance with the well-known side effects of the drugs (oedema and cough) Conclusions: This study showed the antihypertensive effectiveness of perindopril/amlodipine SPC in hypertensive patients previously uncontrolled on two-drug free combinations containing an ARB.

The aim of the study was to evaluated the role of ID ACE gene polymorphism in the development of acute myocardial ishemia in patients with arterial hypertension (HT). Patients with DD genotype were demonstrated a higher risk of myocardial infarction then patients with ID and II genotype. Conversely, the course of HT in II genotypic group is more favorable, but the efficacy of their treatment by traditional agents is minimal.

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