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| |  Ace Inhibitor Aceon (Perindopril) Reduces Systolic And Diastolic Blood Pressure PARIS, FRANCE -- March 21, 2001 -- A study published in the most recent The Journal of Hypertension shows that the antihypertensive perindopril effectively reduces arterial stiffness and improves arterial abnormalities associated with hypertension by significantly reducing systolic and diastolic blood pressure. Available as Aceon Tablets in the U.S., perindopril is an angiotensin converting enzyme (ACE) inhibitor indicated for the treatment of hypertension. Aceon is the newest ACE inhibitor available in the US. Previous studies have suggested that while antihypertensive therapies perform similarly in their ability to lower blood pressure, they vary greatly in their ability to improve the arterial wall properties (structure and function). In addition, other studies show that morbidity and mortality are primarily related to arterial damage, which may begin even in the early stages of hypertension, and may affect one or several organs. "As arteries stiffen due to age and the onset of cardiovascular disease, blood pressure and pulse wave velocity increase, which can contribute to the onset of serious cardiovascular events," said Roland Asmar, M.D., medical director of L'Institut CardioVasculaire, Paris, France and lead investigator of the study. "These study findings bring us a step closer to predicting and preventing these serious events by providing a way to measure arterial stiffness and improve it with treatment available today, such as perindopril." The Journal of Hypertension is published by the International Society of Hypertension and the European Society of Hypertension. The study included over 1,700 patients and is the first international, multicenter large clinical trial to examine the use of long-term antihypertensive treatment to improve arterial stiffness, which was evaluated using the pulse wave velocity (PWV) measurement in hypertensive patients after six months of treatment. PWV is a measurement of the blood vessel's ability to expand and contract with the movement of blood. This elasticity is essential to maintain proper blood flow. The study also showed that assessment of arterial stiffness in large clinical trials in hypertensive patients is feasible using an automatic device called the Complior. The Complior device measures pulse wave velocity by placing two small recording transducers (a signal converting device) on top of the skin. One transducer is positioned at the base of the neck at the common carotid artery and the other on the upper thigh at the femoral artery. The Complior then calculates the time it takes the pulse wave to travel the distance between those two recording sites. This non-invasive measurement provides more detailed information on arterial wall properties than conventional blood pressure measurements. One hundred twenty-nine investigators participated in the six-month study, conducted at 80 centers in 22 countries. Investigators were provided with Complior devices and were required to adhere to national regulatory and custom requirements of each participating country. Participating physicians also attended training sessions on PWV assessment conducted by lead investigators. The study evaluated men and women with untreated essential mild or moderate hypertension, or previously treated hypertension with uncontrolled BP. Eighty-three percent of the patients had never received antihypertensive treatments. Seventeen percent of patients had been previously treated with other antihypertensive therapy. Patients were initially given 4mg of perindopril daily. In 22 percent of patients, the dosing was increased to 8mg daily, and in 11 percent of the patient population a diuretic (indapamide 2.5mg OD) was combined with 8mg of perindopril if blood pressure was uncontrolled. After six months on perindopril, patients experienced significant changes in blood pressure. The average reduction in systolic blood pressure was 24 +/- 17 mmHg and 14 +/- 10 mmHg for diastolic blood pressure. A significant reduction in PWV values was also observed, 0.9 +/- 1.4 after 2 months, and 1.1 +/- 1.4 after six months. This calculates to approximately a 20 percent reduction in arterial stiffness after treatment with perinodopril within a six-month period. "This study is the first step in helping us fully realize the clinical benefits of improving arterial stiffness," said Dr. Asmar. "There are several major worldwide studies underway, which will help further our knowledge in this area as we continue to search for ways to improve outcomes in cardiovascular disease." The reductions in blood pressure were greater in previously untreated patients than in those patients who had been treated for hypertension. However, PWV changes were similar in both groups. Perindopril was first brought to market in France more than 10 years ago as Coversyl, and was introduced in the U.S. as Aceon Tablets in 1999. Perindopril is currently available in over 113 countries and is the first antihypertensive therapy in its class with product labeling describing a decrease in arterial stiffness of large arteries in patients, consistent with the results of animal studies. When used in pregnancy during the second and third trimesters, ACE inhibitors can cause injury and even death to the developing fetus. When pregnancy is detected, perindopril should be discontinued as soon as possible.
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