Short-term antihypertensive efficacy of perindopril according to clinical profile of 3,188 patients: A meta-analysis

Perindopril, a long-acting angiotensin converting enzyme-inhibitor, reduces incidence of cardiovascular end points in a wide range of patients. This effect depends on both the antihypertensive and blood pressure lowering unrelated effects. The aim of the study was to check the possible influence of patients' clinical profile on the antihypertensive efficacy of perindopril. A meta-analysis of individual data of hypertensive patients enrolled in five open studies tested the efficacy and safety of perindopril over a 12-week treatment period. We included data of 3,188 men (39%) and women, aged on average 53 years, whose baseline systolic/diastolic blood pressure averaged 163/99 mm Hg and on average declined by 27/17 mm Hg. Mean duration of hypertension was five years, and 34% of patients had prior cardiovascular complications. We found no difference in the antihypertensive effect of perindopril in patients with complicated vs non-complicated hypertension (DSBP 0.05, 95%CI: -1.5 to 1.6 mm Hg, p = 0.95), in older vs younger patients (DSBP 2.4, 95%CI: -3.2 to 7.9 mm Hg, p = 0.41), in men vs women (DSBP -1.43, 95%CI: -3.4 to 0.5, p = 0.15), and in patients with long-lasting vs shorter duration of hypertension (DSBP 0.0, 95%CI: -1.0 to 1.0 mm Hg, p = 1.0). The antihypertensive effect of perindopril was stronger in patients with greater (> or = 160 mm Hg) systolic blood pressure (DSBP 12.3, 95%CI: 5.5 to 19.0, p = 0.0004). The effect on diastolic blood pressure tended to be greater in younger patients (DDBP -0.63, 95%CI: -1.2 to -0.02 mm Hg, p = 0.04). Perindopril is an effective antihypertensive medication. Seems not to be adversely affected by the clinical profile of the patient.