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ACCOMPLISH trial (Avoiding cardiovascular events through combination therapy in patients living with systolic hypertension)
Subjects:
- 11290 high-risk hypertensive patients
- randomized, double-blind study
- 60% with diabetes
- 50% obese
- 30% with chronic renal insufficiency
- 13% with prior stroke
- 23% with prior myocardial infarction
- 75% on 2 or more antihypertensives at start of study
- 37% had blood pressure < 140/90 at start of study
Treatment groups:
- benazepril/HCTZ (40/25)
- benazepril/amlodipine (40/10)
39 months follow-up
Endpoints:
- cardiovascular death
- myocardial infarction
- stroke
Results:
1) combination of ACE inhibitor/calcium channel blocker better
2) endpoint 20% more likely on diuretic regimen
3) trial stopped early for ethical reasons
General
hypertension clinical trials
References
- Internal Medicine News, vol 41, #8, April 15, 2008
- Jamerson K et al,
Benazepril plus Amlodipine or Hydrochlorothiazide for
Hypertension in High-Risk Patients
N Engl J Med 2008, 359:2417-2428
PMID: 19052124