WEDNESDAY, Dec. 3 (HealthDay News) -- Combination therapy with the angiotensin-converting enzyme inhibitor benazepril and the calcium-channel blocker amlodipine is superior to the treatment combination of benazepril and the diuretic hydrochlorothiazide in preventing cardiovascular events, according to an article published in the Dec. 4 issue of the New England Journal of Medicine.
Kenneth Jamerson, M.D., from the University of Michigan Health System in Ann Arbor, and colleagues conducted a study of 11,506 hypertensive patients who were considered at high risk for cardiovascular events. Patients were randomized to receive either benazepril/amlodipine or benazepril/hydrochlorothiazide. The primary study outcome was a composite of cardiovascular events, including cardiovascular-related mortality, non-fatal myocardial infarction, non-fatal stroke, hospitalization due to angina, resuscitation following sudden cardiac arrest, and coronary revascularization.
The investigators found that more cardiovascular events occurred in the benazepril/hydrochlorothiazide group compared with the benazepril/amlodipine group (11.8 percent versus 9.6 percent, respectively). The benazepril/amlodipine combination resulted in a 19.6 percent relative reduced risk of cardiovascular events, the researchers report. The benazepril/amlodipine combination was also associated with a significantly reduced risk of cardiovascular-related death, myocardial infarction and stroke (hazard ratio, 0.79), the report indicates.
"Our trial shows that combination therapy with benazepril and amlodipine results not only in excellent blood-pressure control but also in a clear benefit with respect to cardiovascular outcomes," the authors conclude. "Thus, our findings may increase the options for combination treatment to reduce the risk of cardiovascular events among patients with hypertension."
The study was supported by Novartis. Authors of the study and editorial report financial relationships with the pharmaceutical industry.
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