Exceptional Early Blood Pressure Control Rates: the Accomplish Trial.
From: University of Michigan Health System, Division of Cardiovascular Medicine, Ann Arbor, Michigan 48106-0739, USA. jamerson@umich.edu
Blood pressure
- Publish Date: 2007
- ISSN: 0803-7051
- Volume: 16
- Issue: 2
- Pages: 80-6
- Medium: Print
- Language: English
- Citation (JAMA): Jamerson Kenneth, Bakris George L, Dahlöf Björn, et al. Exceptional Early Blood Pressure Control Rates: the Accomplish Trial.. Blood Press. 2007;16:80-6
Abstract
BACKGROUND: ACCOMPLISH is a “new-generation” hypertension trial assessing single-tablet combination therapy for initial treatment of high-risk hypertension. At baseline, 97% of subjects were treated with anti-hypertensive medication at entry, but only 37% of participants had blood pressure (BP) control (<140/90 mmHg). Single-tablet combination therapy may improve control rates. METHODS: The mean BP change from baseline at the end of 6 months (the time point when subjects should have had all of the drug titrations to achieve BP control) was examined for 10,704 randomized patients. Within-group changes were examined using t-tests. Comparisons between subgroups were made using analysis of variance (ANOVA) and covariance (ANCOVA). RESULTS: Mean (+/-SD) BP fell from 145+/-18/80+/-11 mmHg at randomization to 132+/-16/74+/-10 mmHg. The 6-month BP control rate was 73% in the overall trial (78% in the US), 43% in diabetics and 40% in patients with renal disease. Of the patients uncontrolled, 61% were not on maximal medications, suggesting potential increases in control rates. Serious hypotensive events occurred in 1.8% of participants. CONCLUSION: ACCOMPLISH BP control rates are the highest of any multi-national trial to date. Whereas current guidelines recommend combination therapy only for stage 2 hypertension, in this trial it is expedient and safe for both stage 1 and 2 hypertension.
Mesh Headings (Keywords): Amlodipine, Antihypertensive Agents, Benzazepines, Blood Pressure, Double-Blind Method, Drug Therapy, Combination, Humans, Hydrochlorothiazide, Hypertension
Check for Full Text / PubMed Unique Identifier (PMID): 17612905
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