ACCOMPLISH, 2008 trial summary    PDF trial summary

A randomised clinical trial investigating the effect of amlodipine plus benazepril versus hydrochlorothiazide plus benazepril in patients with hypertension who were at high risk for cardiovascular events

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NCT00170950    Am J Hypertens 2004;17:793-801  



Studied treatment benazepril 40mg plus amlodipine 5mg daily
amlodipine dose can be increased to 10 mg daily if necessary, to attain a target blood pressure of less than 140/90 mm Hg (or a recommended target of 130/80 mm Hg for patients with diabetes or kidney disease).
Control treatment benazepril 40mg plus hydrochlorothiazide 12.5mg daily
hydrochlorothiazide dose can be increased to 25 mg daily, if necessary, to attain a target blood pressure of less than 140/90 mm Hg (or a recommended target of 130/80 mm Hg for patients with diabetes or kidney disease).
Concomittant treatmentAddition of other antihypertensive agents was permitted (excluding any calcium-channel blockers, any ACE inhibitors, any angiotensin II– receptor blockers, and any thiazide diuretics). Loop diuretics taken once daily were permitted for volume management
BP target 140/90 (130/80 diabetes, kidney disease)
Female (%) 39.5%
Age 68.4 y



Patients patients with hypertension who were at high risk for cardiovascular events
Group sizes5744 / 5762
Inclusion criteriahistory of coronary events, myocardial infarction, revascularization, or stroke; impaired renal function; peripheral arterial disease; left ventricular hypertrophy; diabetes mellitus
Exclusion criteriaangina pectoris; symptomatic heart failure or evidence of left ventricular ejection fraction <40%; myocardial infarction, other acute coronary syndromes, or coronary revascularizations within 1 month; stroke within 3 months; hypertension that is excessively severe, known to be refractory to treatment, or known to have a secondary cause; concomitant illness, physical impairment, or mental condition that could interfere with the effective conduct of the study
Inclusion SBP >=160mmHg ou currently on antihypertensive therapy
Inclusion DBP
Number of selection measures
prior cardiovascular disease
prior stroke 13%
heart failure
Diabetes (%) 60.5%
prior myocardial infarction (%) 23.3%



Blindness double blind Inclusion period oct 2003 - may 2005
Follow-up duration 36 months Centers 548
Lost to FU geographical localisation US, Sweden, Norway, Denmark, Finland
Primary endpoint CV death, MI, stroke, hospitalization for angina, resuscitation, coronary revascularization Design Parallel groups
PeriodeInclusionoct 2003 - may 2005
HypotheseSuperiority
baseline BP 145.3/80.1 mmHg
Isolated systolic hypertension



EndpointX1N1X0N0TE95% CI stroke (fatal & non fatal) 112 5744 133 5762 0,84[0,66; 1,09] Major cardiovascular events 552 5744 679 5762 0,82[0,72; 0,92] non fatal stroke - 5744 - 5762 no data fatal MI - 5744 - 5762 no data Angina - 5744 - 5762 no data coronary heart disease 125 5744 159 5762 0,79[0,62; 1,00] cardiovascular death 107 5744 134 5762 0,80[0,62; 1,04] fatal stroke - 5744 - 5762 no data End stage renal disease - 5744 - 5762 no data Coronary revascularization 334 5744 386 5762 0,87[0,75; 1,01] heart failure - 5744 - 5762 no data all cause death 236 5744 262 5762 0,90[0,75; 1,08] non fatal MI - 5744 - 5762 no data Diabetes onset - 5744 - 5762 no data Peripheral arterial disease - 5744 - 5762 no data0,22,01,0

Jamerson K, Weber MA, Bakris GL, Dahlöf B, Pitt B, Shi V, Hester A, Gupte J, Gatlin M, Velazquez EJ Benazepril plus amlodipine or hydrochlorothiazide for hypertension in high-risk patients. N Engl J Med 2008 Dec 4;359:2417-28     [PMID: 19052124]   link to pdf   add to Mendeley  

Jamerson KA, Bakris GL, Wun CC, Dahlöf B, Lefkowitz M, Manfreda S, Pitt B, Velazquez EJ, Weber MA Rationale and design of the avoiding cardiovascular events through combination therapy in patients living with systolic hypertension (ACCOMPLISH) trial: the first randomized controlled trial to compare the clinical outcome effects of first-line combination therapies in hypertension. Am J Hypertens 2004;17:793-801     [PMID: 15363822]   link to pdf   add to Mendeley  

ClinicalTrial.gov record NCT00170950



Registering number NCT00170950 (see trial on clinicaltrials.gov)
Code Name