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
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 treatment | Addition 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 sizes | 5744 / 5762 |
Inclusion criteria | history of coronary events, myocardial infarction, revascularization, or stroke; impaired renal function; peripheral arterial disease; left ventricular hypertrophy; diabetes mellitus |
Exclusion criteria | angina 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 |
PeriodeInclusion | oct 2003 - may 2005 | ||
Hypothese | Superiority | ||
baseline BP | 145.3/80.1 mmHg | ||
Isolated systolic hypertension |
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
All trials of amlodipine plus benazepril
Appears in following systematic reviews: