What was accomplished in ACCOMPLISH? Review article
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Published:
Dec 31, 2010
Keywords:
amlodypine, benazepril, chronic kidney disease, arterial hypertension
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Abstract
Current guidelines for the management of hypertension acknowledge that 2 or more drugs are likely to be required to achieve blood pressure control (≤130/80 mmHg) in patients with chronic kidney disease and recommend either an ACE inhibitor blocker or an ARB in combination with a thiazide-type diuretic. The ACCOMPLISH trial was designed to test the hypothesis that a combination of an ACE inhibitor with the CCB amlodipine would be superior to the combination of the same ACE inhibitor with HCTZ in reducing a composite of cardiac and stroke events in highrisk hypertensive patients. The main trial showed a 20% relative risk reduction in primary outcome events with benazepril-amlodipine. The subgroup analysis then validated the main results of ACCOMPLISH. Nephrological endpoint was significantly reduced by 47% in the benazeprilamlodipine group compared with the benazepril-HCTZ group in the diabetic patients and by 62% in the nondiabetic subgroup. A combination of a RAS blocker plus amlodipine can now be comfortably recommended to patients considered to have high-risk hypertension.
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Małecki , R. (2010). What was accomplished in ACCOMPLISH?. Medycyna Faktow (J EBM), 3(4(9), 61-69. Retrieved from https://journalsmededu.pl/index.php/jebm/article/view/2565
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References
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10. Gilbertson D.T., Liu J., Xue J.L. et al.: Projecting the number of patients with end-stage renal disease in the United States to the year 2015. J. Am. Soc. Nephrol. 2005; 16: 3736-41.
11. Bakris G.L., Toto R.D., McCullough P.A. et al.; On behalf of the GUARD Study Investigators: Effects of different ACE inhibitor combinations on albuminuria: results of the GUARD study. Kidney Int. 2008; 73: 1303-1309.
12. Weber M.A., Bakris G.L., Jamerson K. et al.: Cardiovascular Events During Differing Hypertension Therapies in Patients With Diabetes. J. Am. Coll. Cardiol. 2010; 56(1): 77-85.
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14. Dahlöf B., Sever P.S., Poulter N.R. et al.; ASCOT Investigators: Prevention of cardiovascular events with an antihypertensive regimen of amlodipine adding perindopril as required versus atenolol adding bendroflumethiazide as required, in the Anglo-Scandinavian Cardiac Outcomes Trial-Blood Pressure Lowering Arm (ASCOT-BPLA): a multicentre randomized controlled trial. Lancet 2005; 366: 895-906.
15. Schmitt K.E., Edie C.F., Laflam P. et al.: Adherence to antihypertensive agents and BP control in chronic kidney disease. Am. J. Nephrol. 2010; 32: 541-548.
16. Bakris G.L., Sarafidis P.A., Weir M.R. et al.: Renal outcomes with different fixed-dose combination therapies in patients with hypertension at high risk for cardiovascular events (ACCOMPLISH): a prespecified secondary analysis of a randomised controlled trial. Lancet 2010; 375(9721): 1173-81.
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19. ACCORD Study Group; Cushman W.C., Evans G.W. et al.: Effects of intensive blood-pressure control in type 2 diabetes mellitus. N. Engl. J. Med. 2010; 362: 1575-1585.
20. Massie B.M., Armstrong P.W., Cleland J.G., Horowitz J.D., Packer M., Poole-Wilson P.A. et al.: Toleration of high doses of angiotensin-converting enzyme inhibitors in patients with chronic heart failure: results from the ATLAS trial. The Assessment of Treatment with Lisinopril and Survival. Arch. Intern. Med. 2001; 161(2): 165-71.
21. de Zeeuw D., Lambers-Heerspink H.: Drug Dosing for Renoprotection: Maybe It’s Time for a Drug Efficacy-Safety Score? J. Am. Soc. Nephrol. 2009; 20: 688-689.
22. Maschio G., Alberti D., Janin G. et al.: Effect of the angiotensin-converting-enzyme inhibitor benazepril on the progression of chronic renal insufficiency. The Angiotensin-Converting-Enzyme Inhibition in Progressive Renal Insufficiency Study Group. N. Engl. J. Med. 1996; 334(15): 939-945.
23. Locatelli F., Del Vecchio L.: How long can dialysis be postponed by low protein diet and ACE inhibitors? Nephrol. Dial. Transplant. 1999; 14: 1360-1364.
24. Hou F.F., Xie D., Zhang X. et al.: Renoprotection of Optimal Antiproteinuric Doses (ROAD) Study: a randomized controlled study of benazepril and losartan in chronic renal insufficiency. J. Am. Soc. Nephrol. 2007; 18(6): 1889-98.
25. Hou F.F., Zhang X., Zhang G.H. et al.: Efficacy and safety of benazepril for advanced chronic renal insufficiency. N. Engl. J. Med. 2006; 354: 131-140.
2. Jungers P., Massy Z.A., Khoa T.N.: Incidence and risk factors of atherosclerotic cardiovascular accidents in predialysis chronic renal failure patients. A prospective study. Nephrol. Dial. Transplant. 1997; 12: 2597-2602.
3. Shlipak M.G., Fried L.F., Stehman-Breen C., Siscovick D., Newman A.B.: Chronic renal insufficiency and cardiovascular events in the elderly. Findings from the Cardiovascular Health Study. Am. J. Geriatr. Cardiol. 2004; 13: 81-90.
4. McAlister F.A., Ezekowitz J., Tonelli M., Armstrong P.W.: Renal Insufficiency and Heart Failure Prognostic and Therapeutic Implications From a Prospective Cohort Study. Circulation 2004 Mar 2; 109(8): 1004-9.
5. Snyder J.J., Foley R.N., Collins A.J.: Prevalence of CKD in the United States: a sensitivity analysis using the National Health and Nutrition Examination Survey (NHANES) 1999–2004. Am. J. Kidney Dis. 2009; 53(2): 218-228.
6. Chobanian A.V., Bakris G.L., Black H.R. et al.: The Seventh Report of the Joint National Committee on prevention, detection, evaluation, and treatment of high blood pressure: the JNC 7 report. JAMA 2003; 289: 2560-2572.
7. Foley R.N., Parfrey P.S., Sarnak M.J.: Epidemiology of cardiovascular disease in chronic renal disease. J. Am. Soc. Nephrol. 1998; 9: S16-S23.
8. Jamerson K., Weber M.A., Bakris G.L.; for the ACCOMPLISH Trial Investigators: Benazepril plus amlodipine or hydrochlorothiazide for hypertension in high-risk patients. N. Engl. J. Med. 2008; 359: 2417-2428.
9. Bakris G.L., Sarafidis P.A., Weir M.R. et al.: Renal outcomes with different fixed-dose combination therapies in patients with hypertension at high risk for cardiovascular events (ACCOMPLISH): a prespecified secondary analysis of a randomized, controlled trial, Lancet 2010; 375: 1173-81.
10. Gilbertson D.T., Liu J., Xue J.L. et al.: Projecting the number of patients with end-stage renal disease in the United States to the year 2015. J. Am. Soc. Nephrol. 2005; 16: 3736-41.
11. Bakris G.L., Toto R.D., McCullough P.A. et al.; On behalf of the GUARD Study Investigators: Effects of different ACE inhibitor combinations on albuminuria: results of the GUARD study. Kidney Int. 2008; 73: 1303-1309.
12. Weber M.A., Bakris G.L., Jamerson K. et al.: Cardiovascular Events During Differing Hypertension Therapies in Patients With Diabetes. J. Am. Coll. Cardiol. 2010; 56(1): 77-85.
13. Vupputuri S., Batuman V., Muntner P.: Effect of blood pressure on early decline in kidney function among hypertensive men. Hypertension 2003; 42: 1144-1149.
14. Dahlöf B., Sever P.S., Poulter N.R. et al.; ASCOT Investigators: Prevention of cardiovascular events with an antihypertensive regimen of amlodipine adding perindopril as required versus atenolol adding bendroflumethiazide as required, in the Anglo-Scandinavian Cardiac Outcomes Trial-Blood Pressure Lowering Arm (ASCOT-BPLA): a multicentre randomized controlled trial. Lancet 2005; 366: 895-906.
15. Schmitt K.E., Edie C.F., Laflam P. et al.: Adherence to antihypertensive agents and BP control in chronic kidney disease. Am. J. Nephrol. 2010; 32: 541-548.
16. Bakris G.L., Sarafidis P.A., Weir M.R. et al.: Renal outcomes with different fixed-dose combination therapies in patients with hypertension at high risk for cardiovascular events (ACCOMPLISH): a prespecified secondary analysis of a randomised controlled trial. Lancet 2010; 375(9721): 1173-81.
17. Rashidi A., Wright J.T.: Drug Treatment of Hyper tension in Older Hypertensives. Clin. Geriatr. Med. 2009; 25: 235-244.
18. Mancia G., Laurent S., Agabiti-Rosei E. et al.: European Society of Hypertension. Reappraisal of European guidelines on hypertension management: a European Society of Hypertension Task Force document. J. Hypertens. 2009; 27: 2121-2158.
19. ACCORD Study Group; Cushman W.C., Evans G.W. et al.: Effects of intensive blood-pressure control in type 2 diabetes mellitus. N. Engl. J. Med. 2010; 362: 1575-1585.
20. Massie B.M., Armstrong P.W., Cleland J.G., Horowitz J.D., Packer M., Poole-Wilson P.A. et al.: Toleration of high doses of angiotensin-converting enzyme inhibitors in patients with chronic heart failure: results from the ATLAS trial. The Assessment of Treatment with Lisinopril and Survival. Arch. Intern. Med. 2001; 161(2): 165-71.
21. de Zeeuw D., Lambers-Heerspink H.: Drug Dosing for Renoprotection: Maybe It’s Time for a Drug Efficacy-Safety Score? J. Am. Soc. Nephrol. 2009; 20: 688-689.
22. Maschio G., Alberti D., Janin G. et al.: Effect of the angiotensin-converting-enzyme inhibitor benazepril on the progression of chronic renal insufficiency. The Angiotensin-Converting-Enzyme Inhibition in Progressive Renal Insufficiency Study Group. N. Engl. J. Med. 1996; 334(15): 939-945.
23. Locatelli F., Del Vecchio L.: How long can dialysis be postponed by low protein diet and ACE inhibitors? Nephrol. Dial. Transplant. 1999; 14: 1360-1364.
24. Hou F.F., Xie D., Zhang X. et al.: Renoprotection of Optimal Antiproteinuric Doses (ROAD) Study: a randomized controlled study of benazepril and losartan in chronic renal insufficiency. J. Am. Soc. Nephrol. 2007; 18(6): 1889-98.
25. Hou F.F., Zhang X., Zhang G.H. et al.: Efficacy and safety of benazepril for advanced chronic renal insufficiency. N. Engl. J. Med. 2006; 354: 131-140.