CLIP-ACCORD: focus on full-dose combination

In CLIP-ACCORD study, 6000 patients from 21 cities of Russia, Ukraine, and Belorussia are participating. Aim. To study antihypertensive efficacy and safety of fixed-dose combination of enalapril and thiazide diuretic hydrochlorthiazide (Co-Renitec ®) among patients with arterial hypertension (AH) and high or very high risk of cardiovascular complications (CVC), in real-world clinical practice settings. Material and methods. CLIP-ACCORD is a multi-center, international, open prospective program. At present, 4224 AH patients (37% of males, 63% of females, aged 20-85 years; mean AH duration 8.4±7.6 (0-50) years) completed study protocol. The program included AH patients with high or very high CVD risk; antihypertensive therapy, if any, was ineffective. Co-Renitec® was administered once per day, at 8-10 AM. If target blood pressure (BP) level was achieved 4 weeks later, therapy in the same dose continued for another 8 weeks. Otherwise, Co-Renitec® dose was increased, and/or other antihypertensive agent was added. Full data were available for 4203 participants. Results. At baseline, BP was at Stage I AH level (National Cardiology Society classification, 2004) in 3% of patients; at Stage II level – in 67%; and at Stage III level – in 30%. After four-week Co-Renitec® treatment, complete BP normalization was achieved in 41% of participants, Stage I BP was registered in 40% of patients, Stage II – in 18%, and Stage III – in 1%. Co-Renitec® dose was increased in 26% of patients; other antihypertensive medications were added in 15%. After 12 weeks of Co-Renitec® treatment, target BP levels were achieved in 82% of patients. AH clinical symptoms improved in 98% of participants. After program end, 98% of participants continued CoRenitec® intake. Conclusion. Co-Renitec® antihypertensive therapy in AH patients with high and very high CVC risk was effective in full-dose combination, and facilitated target BP level achievement in 82% of patients.

1. Рекомендации по профилактике, диагностике и лечению артериальной гипертензии. Российские рекомендации (второй пересмотр). Комитет экспертов Всероссийского научного общества кардиологов. Секция артериальной гипертонии ВНОК. Москва 2004. Приложение к журналу «Кардиоваск тер профил»

2. 1999 World Health Organization – International Society of Hypertension Guidelines for the Management of Hypertension. J Hypertens 1999; 17: 151-83.

3. 2003 European Society of Hypertension – European Society of Cardiology Guidelines for the management of arterial hypertension. J Hypertens 2003; 21: 1011-53.

4. Chobanian AV, Bakris GL, Blorck HR, et al. The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation and Treatment of High Blood Pressure. JAMA 2003; 289: 2560-72.