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Achieving blood preSsure goals sTudy in uncontrolled hypeRtensive pAtients treated with a fixed-dose combination of ramipriL / hydrochlorothiazide : the ASTRAL study

2011; Clinics Cardive Publishing; Volume: 22; Issue: 2 Linguagem: Inglês

10.5830/cvja-2010-086

1680-0745

Ikechi G. Okpechi, H.S. Schoeman, Benjamin Longo‐Mbenza, David Oke, Samuel Kingué, J. L. Nkoua, Brian Rayner,

Heart Rate Variability and Autonomic Control

Background: Hypertension is a common cardiovascular disease, affecting adults worldwide and it accounts for up to 30% of all deaths.The need for better control of arterial hypertension justifies observational studies designed to better understand the real-life management of hypertensive patients.The ASTRAL study was primarily designed to evaluate the percentage of hypertensive patients achieving blood pressure goals after eight weeks of treatment with a fixeddose combination of ramipril/hydrochlorothiazide (HCTZ). Methods: The study was a multi-centre, non-comparative, open-label, observational study conducted in 36 centres in five sub-Saharan African countries, namely Cameroon, Congo Brazzaville, Democratic Republic of Congo (DRC), Madagascar and Nigeria.Four hundred and forty-nine men and women 18 years of age or older with hypertension not controlled by an ACE inhibitor, a diuretic or any other monotherapy or anti-hypertensive combination not containing a diuretic in a fixed dose were considered eligible for inclusion in this eight-week study.The study consisted of three visits, visit one (V1) at baseline, visit two (V2) after four weeks and visit three (V3) after eight weeks.Results: The mean age of the patients was 54.7 ± 11.7 years (20-90 years) and most were categorised by the WHO criteria as either overweight or obese (71.6%).After four and eight weeks of treatment with the study drug, systolic and diastolic blood pressures significantly changed from baseline:-24.7/-14.2mmHg (p < 0.001) and -31.7/-17.9mmHg (p < 0.001), respectively.There were 60.2% of the non-diabetics on prior monotherapy who, at eight weeks, fulfilled the primary blood pressure goal for SBP and DBP, versus 26.5% of the diabetic patients, also on monotherapy.Few adverse events were reported, with facial oedema and dry cough recurring twice in two patients.Conclusion: Fixed-dose combination of ramipril/HCTZ is therefore effective, tolerable and has a good safety profile for blood pressure control in black Africans.