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Systematic review and meta-analysis

This trial is included in the following systematic reviews and meta-analyses:

diabetes - anti hypertensive agent - type1 and 2 diabetic patients with hypertension

hypertension - anti hypertensive agent - diabetic patients


Related trials

ACCOMPLISH (diabetic subgroup), 2010 - benazepril + amlodipine vs benazepril + hydrochlorothiazide

ACCORD blood pressure, 2010 - more intensive blood pressure lowering strategie vs less intensive blood pressure lowering strategie

AVOID, 2008 - aliskiren vs placebo

ABCD (N), 2002 - more intensive blood pressure lowering strategie vs less intensive blood pressure lowering strategie

ALLHAT (lisi vs chlor, diabetic subgroup), 2002 - lisinopril vs chlorthalidone

LIFE (diabetic subgroup), 2002 - losartan vs atenolol

ALLHAT (amlodipine vs chlor, diabetic subgroup), 2002 - amlodipine vs chlorthalidone

IPDM, 2001 - irbesartan vs placebo

IDNT amlodipine, 2001 - amlodipine vs placebo

RENAAL, 2001 - losartan vs placebo

IDNT irbesartan, 2001 - Irbesartan vs placebo

IDNT (irbesartan vs amlodipine), 2001 - Irbesartan vs amlodipine

STOP-2 CCB (diabetic subgroup), 2000 - calcium-channel blocker vs diuretic or beta-blocker

INSIGHT (diabetic subgroup), 2000 - Nifedipine vs coamilozide

ABCD (H), 2000 - more intensive blood pressure lowering strategie vs less intensive blood pressure lowering strategie

NORDIL (diabetic subgroup), 2000 - Diltiazem vs diuretic or beta-blocker

STOP-2 (ACEI vs CCB) (diabetic subgroup), 2000 - ACE inhibitor vs CCB

HOPE (diabetic subgroup), 2000 - ACE inhibitor vs placebo

STOP-2 ACEI (diabetic subgroup), 2000 - ACE inhibitor vs diuretic or beta-blocker

CAPP (diabetic subgroup), 1999 - captopril vs diuretic or beta-blocker

Syst-Eur (diabetic subgroup), 1999 - nitrendipine vs placebo

ABCD, 1998 - nisoldipine vs enalapril

UKPDS 38, 1998 - captopril or atenolol vs control

UKPDS 39, 1998 - captopril vs atenolol

FACET, 1997 - amlodipine vs fosinopril



See also:

  • All diabetes clinical trials
  • All hypertension clinical trials
  • All clinical trials of anti hypertensive agent
  • All clinical trials of benazepril + amlodipine
    		•  

    ACCOMPLISH (diabetic subgroup) study, 2010

    [NCT00170950] Facebook    pdf : benazepril + amlodipine - anti hypertensive agent for hypertension

    Treatments

    Studied treatment benazepril, combined with amlodipine
    starting doses of benazepril 20 mg/day plus amlodipine 5 mg/day. amlodipine dose could be increased to 10 mg/day if required to achieve a target blood pressure goal of <140/90 mm Hg. For the diabetic patients a target blood pressure of <130/80 mmHg was recommended, but not mandated
    Control treatment benazepril, combined with hydrochlorothiazide
    starting doses of benazepril 20 mg/day plus hydrochlorothiazide 12.5 mg/day. hydrochlorothiazide dose could be increased to 25 mg/day if required to achieve a target blood pressure goal of <140/90 mm Hg. For the diabetic patients a target blood pressure of <130/80 mmHg was recommended, but not mandated
    Remarks if needed investigators could add other antihypertensive agents as beta-blockers, clonidine, alpha-blockers, and spironolactone

    Patients

    Patients patients with diabetes (subgroup) and hypertension at high risk of cardiovascular and related events
    Inclusion criteria >=60 years of age; systolic BP >=160 mm Hg or currently on antihypertensive therapy; evidence of cardiovascular or renal disease or target organ damage; patients aged 55 to 59 years are eligible if they have evidence of two or more of the cardiovascular diseases or target organ damage
    Exclusion criteria current evidence for angina pectoris; history of symptomatic heart failure or evidence of left ventricular ejection fraction <40%; myocardial infarction, other acute coronary syndromes, or coronary revascularizations within 1 month; stroke or other ischemic cerebrovascular episodes 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
    Remarks Of the all 11505 patients included in the trial, 6946 had diabetes (and 2842 high risk diabetes)
    Baseline characteristics
    Glycosylated hemoglobin NA 
    BP (systolic/diastolic) 145.2/79.3 mmHg 
    Female (%) 43% 
    Age 67.5 y 
    subgroup yes 
    hypertension (%) 100% 

    Method and design

    Randomized effectives 3478 / 3468 (studied vs. control)
    Design Parallel groups
    Blinding double-blind
    Follow-up duration 36 months
    Number of centre 548
    Geographic area US, Norway, Denmark, Finland
    Hypothesis Superiority
    Primary endpoint cardiovascular morbidity and mortality


    Results

    Endpoint Studied treat.
    n/N     Control treat.
    n/N     Graph RR [95% CI]

    cardiovascular event (fatal and non fatal)

    307 / 3478
         383 / 3468
         0,80 [0,69;0,92]     0 2 1.0

    Relative risks
    Endpoint Events (%) Relative Risk 95% CI Endpoint definition
    in the trial    		 Ref
    Studied treat. Control treat.
    cardiovascular event (fatal and non fatal) 307 / 3478 (8,8%) 383 / 3468 (11,0%) 0,80 [0,69;0,92]   13212 
    The primary endpoint (if exists) appears in blod characters
    Reference(s) used for data extraction:
  • 13212: Weber MA, Bakris GL, Jamerson K, Weir M, Kjeldsen SE, Devereux RB, Velazquez EJ, Dahl�f B, Kelly RY, Hua TA, Hester A, Pitt BCardiovascular events during differing hypertension therapies in patients with diabetes.J Am Coll Cardiol 2010;56:77-85

    • Endpoint studied treat. control treat. mean diff

    Absolute risk reduction
    Endpoint Events rate Absolute risk
    reduction (ARR)
    Studied treat. Control treat.
    cardiovascular event (fatal and non fatal) 8,83% 11,04% -22,2‰

    Meta-analysis of all similar trials:

    anti hypertensive agent in diabetes for type1 and 2 diabetic patients with hypertension

    anti hypertensive agent in hypertension for diabetic patients



    Reference(s)

    Trials register # NCT00170950
    • Weber MA, Bakris GL, Jamerson K, Weir M, Kjeldsen SE, Devereux RB, Velazquez EJ, Dahl�f B, Kelly RY, Hua TA, Hester A, Pitt B. Cardiovascular events during differing hypertension therapies in patients with diabetes.. J Am Coll Cardiol 2010;56:77-85 - 10.1016/j.jacc.2010.02.046
      Pubmed | Hubmed | Fulltext
    • Jamerson K, Weber MA, Bakris GL, Dahl�f 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;359:2417-28 - 10.1056/NEJMoa0806182
      Pubmed | Hubmed | Fulltext

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