6/27/23, 11:46 PM ACCOMPLISH Pathway Feedback Search Clinical Topics Home Studies ACCOMPLISH ACCOMPLISH Disease Hypertension Trial question Is benazepril plus amlodipine superior to benazepril plus hydrochlorothiazide in patients with hypertension who are at high-risk for cardiovascular events? Study design Multi-center Double blinded RCT Population Characteristics of study participants 39.0% female N = 11506 61.0% male 11506 patients (4542 female, 6963 male) Inclusion criteria: patients with hypertension who were at high risk for cardiovascular events Key exclusion criteria: acute coronary syndromes, or coronary revascularizations within 1 month of the first visit; stroke or other ischemic cerebrovascular episodes within 3 months preceding study evaluation; or hypertension that is excessively severe, known to be refractory to treatment, or known to have a secondary cause Interventions N=5744 benazepril-amlodipine (20 mg benazepril and 5 mg amlodipine) N=5762 benazepril-hydrochlorothiazide (20 mg benazepril and 12.5 mg hydrochlorothiazide) https://web.pathway.md/studies/recFGSRsEiKbZY0ML 1/2 6/27/23, 11:46 PM ACCOMPLISH Pathway Primary outcome Rate of cardiovascular events and death from cardiovascular causes, at a mean follow-up of 36 months 11.8 % 11.8 9.6 8.9 % 5.9 % Significant decrease 3.0 % NNT = 45 0.0 % Benazepril-amlodipine Benazepril-hydrochlorothiazide Significant decrease in the rate of cardiovascular events and death from cardiovascular causes, at a mean follow-up of 36 months (9.6% vs. 11.8%; HR 0.8, 95% CI 0.72 to 0.9) Secondary outcomes Significant decrease in death from cardiovascular causes, nonfatal myocardial infarction, and nonfatal stroke (5% vs. 6.3%; HR 0.79, 95% CI 0.67 to 0.92) Significant decrease in cardiovascular events (8.6% vs. 10.3%; HR 0.83, 95% CI 0.73 to 0.93) Safety outcomes No significant difference in dry cough (20.5% vs. 21.2%) and hyperkalemia (0.6% vs. 0.6%). Significant differences in peripheral edema (31.2% vs. 13.4%), dizziness (20.7% vs. 25.4%), and hypotension (2.5% vs. 3.6%). Conclusion In patients with hypertension who were at high risk for cardiovascular events, benazepril-amlodipine was superior to benazepril-hydrochlorothiazide with respect to the rate of cardiovascular events and death from cardiovascular causes, at a mean follow-up of 36 months. Reference Jamerson K, Weber MA, Bakris GL et al. Benazepril plus amlodipine or hydrochlorothiazide for hypertension in high-risk patients. N Engl J Med. 2008 Dec 4;359(23):2417-28. Open reference URL https://web.pathway.md/studies/recFGSRsEiKbZY0ML 2/2