ACCOMPLISH
Avoiding Cardiovascular Events through Combination Therapy in Patients Living with Systolic Hypertension
Patient / Population Intervention / Exposure Comparison Outcome
In 11,506 high-risk patients with hypertension, an ACE inhibitor plus amlodipine reduced cardiovascular events compared with an ACE inhibitor plus hydrochlorothiazide.
N
11,506
Design
Double-blind RCT, stopped early
Endpoint
CV death, MI, stroke and related events
Relevance
2
Result9.6 % vs 11.8 % (HR 0.80).
Jamerson K, et al. N Engl J Med. 2008;359(23):2417-2428. 10.1056/NEJMoa0806182
Discussion & critique
Challenged thiazide-based combinations. Used hydrochlorothiazide rather than chlorthalidone, and the office-BP equivalence between arms complicates interpretation.