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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

Authors Grimm R, Malik M, Yunis C, Sutradhar S, Kursun A

Published 16 April 2010 Volume 2010:6 Pages 261—271

DOI https://doi.org/10.2147/VHRM.S7710

Review by Single-blind

Peer reviewer comments 2


Richard Grimm1, Mobin Malik1, Carla Yunis2, Santosh Sutradhar2, Attila Kursun2 on behalf of the TOGETHER Investigators

1Berman Center for Outcomes and Clinical Research, University of Minnesota, Minneapolis, MN, USA; 2Pfizer Inc, New York, NY, USA

Abstract: 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

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