Is Time an Important Problem in Management of Hypertension and Hypercholesterolemia by Using an Amlodipine-Atorvastatin Single Pill Combination?

Abstract

BACKGROUND Is the timing of dosing for amlodipine and atorvastatin important with regard to therapeutic efficacy? To answer this question, we designed an outpatient, practice-based, case-control study lasting 8 weeks. MATERIAL AND METHODS Two hundred patients were divided into 2 groups: in Group I, patients were provided with a single pill containing amlodipine/atorvastatin (5/20 mg) to be taken each night at 10 pm, and in Group II, patients were taking amlodipine (5 mg) and atorvastatin (20 mg) each morning at 7 am. RESULTS Our results indicated no obvious difference in blood pressure control between the 2 groups. Taking amlodipine at night not only lowered blood pressure, but it also provided better control during the peak blood pressure in the morning. Hypercholesterolemia control in the 2 groups was also not significantly different, taking atorvastatin in the morning was as effective as dosing at night in patients with hypercholesterolemia. While the carotid IMT, hs-CRP, and LVMI were significantly lower after treatment, no differences were found between the 2 groups. Although no obvious difference was found in adverse drug reactions between the 2 groups, compliance was much better in the single-pill group than in patients taking the 2 medications separately. CONCLUSIONS In conclusion, single-pill amlodipine-atorvastatin taken at night can lower blood pressure and reduce the morning peak blood pressure levels the next day. Additionally, this dosing method could improve patient adherence to the therapy.

Figure 1

Flow diagram of this research. AML – Amlodipine; ATO – Atorvastatin.

Figure 2

Comparison of blood pressure before and after treatment in both groups. There was no statistically significant change in D-value except in the morning peak group. In Group I, the morning peak BP reduction in SBP and DBP at week 8 was markedly less than in Group II (P<0.05).

Figure 3

Comparison of serum lipid levels before and after treatment in both groups. There were no significant differences in the D-values of TC, TG, and LDL-C or HDL-C before and after 8-week treatment (P>0.05).

Figure 4

Comparison of hs-CRP, LVMI, and carotid -IMT before and after treatment in both groups. There were no significant differences in the D-values of hs-CRP, LVMI, and IMT before and after 8-week treatment (P>0.05).