Andrew Schamess
The randomized double-blind ACCOMPLISH trial enrolled 11 462 patients in the United States and Nordic countries. Participants, who were aged 55 years or older (average age was 68 years) and who were at high risk for cardiovascular disease (systolic blood pressure ≥160 mm Hg, or currently on antihypertensive therapy and who had evidence of cardiovascular or renal disease), were to be followed up for 36 months before the trial was halted. Patients were randomly assigned to receive a pill containing both benazepril (an ACE inhibitor) and amlodipine (a CCB) or a pill containing both benazepril and hydrochlorothiazide (a diuretic). The study was funded by Novartis Pharmaceuticals Corp, East Hanover, NJ, which manufactures a CCB/ACE inhibitor combination therapy in a range of doses.
At 30 months, blood pressure of patients in both treatment groups decreased to a mean of about 130 mm Hg systolic and about 80 mm Hg diastolic, but those receiving the CCB/ACE inhibitor combination experienced 20% less cardiovascular morbidity and mortality (defined as cardiovascular deaths, myocardial infarctions, stroke, hospitalization for unstable angina, and revascularization) compared with the other group.
medicine prevention hypertension cardiology
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