AMLODIPINE/BENAZAPRIL 联合治疗效果更好

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COMBINATION OF AMLODIPINE/BENAZAPRIL IS SUPERIOR TO HYDROCHLOROTHIAZIDE/BENAZAPRIL IN REDUCING CV MORBIDITY AND MORTALITY

CHICAGO, Il – ACCOMPLISH (Avoiding Cardiovascular Events Through COMbination Therapy in Patients LIving with Systolic Hypertension) is the first trial to evaluate cardiovascular outcomes using single pill, fixed-dose combination therapy for the treatment of high-risk hypertensive patients. The trial was terminated early and the interim results presented today at the American College of Cardiology’s 57th Annual Scientific Session. Patients with hypertension and high risk for cardiovascular complications experienced 20 percent fewer events (cardiovascular death, heart attacks, strokes, hospitalizations for unstable angina and need for coronary heart procedures) when treated with a combination of an ace inhibitor and calcium channel blocker (ace/ccb) compared to a combination of an ace inhibitor and hydrochlorothiazide (ace/hctz).

The ACCOMPLISH investigators demonstrated that the ace/ccb tablet not only reduced death from heart attacks but also retarded the progression of heart disease by reducing the number of heart attacks, hospitalizations for unstable heart blockages, and even the need for procedures to open clogged arteries to the heart. The strategies used in ACCOMPLISH differ from the current guidelines most clinicians follow. Current guidelines recommend initial treatment with tablets that contain one drug. Importantly, present guidelines recommend diuretics as initial therapy for most hypertensive subjects.
Most people with hypertension do not have adequate control of their blood pressure. Similarly, only 37 percent of the participants in the ACCOMPLISH trial had adequate control prior to entry into the trial. The use of combination tablets as the initial drug treatment more than doubled the number of patients that achieved adequate control.

Moreover, the use of ace/ccb combination tablet provided superior cardiovascular protection when compared to the diuretic-based therapy.

“The ACCOMPLISH trial demonstrates the superiority of an ace/ccb pill fixed-dose combination treatment strategy for reducing cardiovascular morbidity and mortality and provides evidence to modify future hypertension guidelines,” said lead investigator of the ACCOMPLISH study Kenneth Jamerson, M.D., Professor, University of Michigan. Dr. Jamerson added, “ACCOMPLISH was both an innovation in hypertension trial design (initial combination rather than monotherapy) and challenged a standard of care in the management of hypertension (diuretic based therapy).”

The Novartis-funded ACCOMPLISH trial achieved exceptional blood pressure control and reduced cardiovascular morbidly and mortality by 20 percent with the use of a combination tablet containing an ace inhibitor/calcium channel blocker. The results provide important new health benefits for the millions at risk of complications from hypertension.

Dr. Jamerson will present this study, “Avoiding Cardiovascular Events Through COMbination Therapy in Patients LIving with Systolic Hypertension, the Early Termination of the ACCOMPLISH Trial for Efficacy” on Monday, March 31 at 10:00 a.m. in North Hall B1.
氨氯地平和苯那普利联合治疗优于氢氯噻嗪和苯那普利联合：降低心血管 的并发症和死亡率

芝加哥，- ACCOMPLISH （通过联合治疗收缩期高血压, 避免心血管事件），是第一次对高危高血压患者，用单片，固定剂量药物联合治疗，来评价心血管的治疗结果的临床试验。
这个试验刚刚结束，初步结果在 美国心脏病学院第57届年科学会上报道。（American College of Cardiology’s 57th Annual Scientific Session.）ACEI 与 钙通常阻滞剂 (ace/ccb)联合，比ACEI与利尿剂联合(ace/hctz)治疗，病人血压高和高危心血管并发症事件(心血管疾病死亡,心肌梗死,中风, 不稳定心绞痛和需要冠脉手术）减少了20%.ACCOMPLISH研究者发现， ace/ccb联合治疗，不但减少了心脏病的死亡率，通过减少心梗的发作次数，减少不稳定心绞痛和需要需要冠脉手术的住院次数， 因为也延缓心脏病的进程。ACCOMPLISH治疗方案与目前流行的，大多数临床医生遵循的原则不一样。目前推荐的治疗原则是用一种药物。尤其应注意的是，目前的治疗原则推荐利尿剂作为大多数高血压患者的首选治疗。然而，大多数高血压患者控制血压并不理想。同样的，只有37%的参与ACCOMPLISH试验的患者，在试验前血压控制是理想的。相反，用联合治疗作为初始治疗后，有2倍的病人血压能控制到理想状态。而且，ace/ccb联合，相对于以利尿剂为基础的治疗，对心血管系统提供了更好的保护。“ACCOMPLISH 试验表明， ace/ccb 固定剂量联合治疗方案的优越性，降低心血管疾病 的并发症和死亡率，为改进以后的高血治疗原则提供了依据”。密歇根大学，ACCOMPLISH 的领导者，Kenneth Jamerson 博士说。Jamerson医生补充说：ACCOMPLISH不但改进高血压治疗的设计（联合优于单药），他对现行标准的治疗方案提出了挑战（以利尿为基础方案的治疗）。诺华资助的ACCOMPLISH 试验取得了意外的成功，ACEI 与 钙通常阻滞剂 (ace/ccb)联合降低20%心血管 的并发症和死亡率。这结果将使成千上万的的面临高血压并发症困扰的患者受益。