Comparison of the pharmacokinetics and pharmacodynamics of oral doses of perindopril in normotensive Chinese and Caucasian volunteers.

Abstract

1. The pharmacokinetics of perindopril and perindoprilat and the hormonal and haemodynamic responses following a single oral dose were studied in 12 Chinese and 10 Caucasian healthy, normotensive volunteers on two occasions. Perindopril was given on the first occasion as a 4 mg dose and then after at least 10 days as a weight‐adjusted dose of 4 mg/70 kg. Plasma was sampled for assay of perindopril, perindoprilat, plasma renin activity (PRA), aldosterone, angiotensin I (AI) and ACE activity. Urine was collected for perindopril and perindoprilat assay. A radioimmunoassay technique was used to measure the prodrug and its active metabolite. 2. The time to maximum concentration (tmax) for perindopril was shorter for the Chinese group after the 4 mg dose (median 0.5, range 0.5‐1.5 h vs median 1.0, 0.5‐1.5 h P < 0.05) and also tended to be shorter after the weight‐adjusted dose (median 0.5, range 0.5‐1.0 h vs median 1.0, range 0.5‐3.0 h). Cmax and AUC tended to be higher after the 4 mg dose in the Chinese group who had a lower body weight than the Caucasians. 3. The tmax of perindoprilat tended to be shorter for both doses and there was a tendency towards a higher Cmax after the 4 mg dose in the Chinese group but there was no statistically significant difference between the two groups. 4. There were no differences in the levels of PRA, plasma AI, plasma aldosterone or the degree of ACE‐inhibition for either dose in the two ethnic groups. 5. Blood pressure was measured at intervals up to 24 h post‐dose in both the supine and standing positions. Perindopril reduced blood pressure acutely with respect to the pre‐dose level with good tolerability in both groups.(ABSTRACT TRUNCATED AT 250 WORDS)

The Treatment Effect of an ACE-Inhibitor Based Regimen with Perindopril in Relation to Beta-Blocker use in 29,463 Patients with Vascular Disease: a Combined Analysis of Individual Data of ADVANCE, EUROPA and PROGRESS Trials

“…The beta-blockers metoprolol and bisoprolol are the types most frequently prescribed in the world. Bisoprolol is a long-acting beta-blocker that is predominantly selective for β1-adrenoreceptors and that can be combined with perindopril in a single-pill formulation because, like perindopril, it has a 24-h duration of action [ 7 , 40 , 41 ]. Bisoprolol also benefits from a well-documented safety profile and has been classified as an essential drug for hypertension, angina, heart failure, and arrhythmia by the World Health Organization [ 42 ].…”

“…Perindopril is a widely prescribed ACE-inhibitor that is supported by extensive pharmacokinetic, pharmacodynamic, blood pressure, and outcome studies [ 7 – 12 ]. A previous meta-analysis of the large EUROPA, ADVANCE, and PROGRESS trials, which included a wide range of patients with vascular disease, showed that perindopril-based regimens improved survival and reduced the risk of having a major cardiovascular event [ 13 ].…”