Simultaneous treatment to attain blood pressure and lipid goals and reduced CV risk burden using amlodipine/atorvastatin single-pill therapy in treated hypertensive participants in a randomized controlled trial

• Main Authors: Richard Grimm, Mobin Malik, Carla Yunis, et al
• Format: Article
• Language: English
• Published: Dove Medical Press 2010-04-01
• Series: Vascular Health and Risk Management
• Online Access: http://www.dovepress.com/simultaneous-treatment-to-attain-blood-pressure-and-lipid-goals-and-re-a4264
• ISSN: 1176-6344; 1178-2048

Richard Grimm1, Mobin Malik1, Carla Yunis2, Santosh Sutradhar2, Attila Kursun2 on behalf of the TOGETHER Investigators1Berman Center for Outcomes and Clinical Research, University of Minnesota, Minneapolis, MN, USA; 2Pfizer Inc, New York, NY, USAAbstract: TOGETHER investigated whether targeting multiple cardiovascular (CV) risk factors using single-pill amlodipine/atorvastatin (AML/ATO) and therapeutic lifestyle changes (TLC) results in greater blood pressure (BP)/lipid control and additional reduction in estimated cardiovascular disease (CVD) risk compared with blood pressure intervention only using amlodipine (AML) + TLC. TOGETHER was a 6-week, randomized, double-blind, double-dummy trial using hypertensive participants with additional CV risk factors without CVD/diabetes. Participants were randomized to either AML/ATO (5 to 10/20 mg) + TLC or AML (5 to 10 mg) + TLC. The primary end point was the difference in proportion of participants attaining both BP (<140/90 mm Hg) and low-density lipoprotein cholesterol (LDL-C) (<100 mg/dL) goals at week 6. At week 6, 67.8% of participants receiving AML/ATO + TLC attained the combined BP/LDL-C goal versus 9.6% with AML + TLC (RD [A–B]: 58.2; 95% CI [48.1 to 68.4] P < 0.001; OR: 19.0; 95% CI 9.1 to 39.6; P < 0.001). Significant reductions from baseline in LDL-C, total cholesterol and triglycerides and estimated 10-year Framingham risk were also observed. Treatment with AML/ATO was well tolerated. In conclusion, a multifactorial CV management approach is more effective in achieving combined BP/LDL-C targets as well as CV risk reduction compared with BP intervention only in this patient population.Keywords: blood pressure, calcium channel blocker, low-density lipoprotein cholesterol, statin