TREATMENT OF ESSENTIAL-HYPERTENSION IN GENERAL-PRACTICE - AN OPEN-LABEL STUDY OF 47,351 FRENCH HYPERTENSIVE PATIENTS TREATED FOR ONE-YEAR WITH PERINDOPRIL

The efficacy and acceptability of perindopril were assessed over one y ear by 4800 French general practitioners in an open label study of 47, 351 freely consenting adults with mild to moderate hypertension. Perin dopril was administered as a single daily dose each morning. The start ing dose of 4 mg (or 2 mg in patients over 70 years) was doubled after one month, to a maximum of 8 mg if diastolic blood pressure (DBP) was greater than 95 mmHg. Thereafter a non-potassium sparing diuretic was added to the 8 mg dose if necessary. At 12 months, effective blood pr essure control, defined as recumbent DBP below 90 mmHg, was achieved i n between 68 and 71% of patients. The majority of patients (80% [n=37, 348]) received perindopril alone throughout the 12-month study period. final prescription (at six months) revealed that 65% of patients were treated with the once daily 4 mg dose. Throughout the 12 months of th e study, 7.6% of patients (n=3564) discontinued treatment, 5.1% (n=240 1) due to adverse events land 0.4% (n=187) due to fatal events (princi pally cardiovascular reasons). Cough was the most frequent adverse sym ptom, leading to withdrawal of 3.28% of patients; this symptom was spo ntaneously reported in an additional 6.4% of patients throughout the o ne-year period but did not lead to discontinuation. All other adverse events leading to withdrawal were present in less than 0-4% of cases. The majority of fatal outcomes was due to cardiovascular events (n=78) , 37 were due to cancer, 19 due to road accidents and 53 due to miscel laneous causes. In conclusion, bearing in mind the need for caution wh en interpreting the results of an open-label study, the treatment of 4 7,351 hypertensive patients for one year in a general practice setting showed perindopril to be effective and well tolerated.