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George L Bakris - One of the best experts on this subject based on the ideXlab platform.
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Clinical Trial Efficacy and Duration of Benazepril Plus Amlodipine or Hydrochlorthiazide on 24-Hour Ambulatory Systolic Blood Pressure Control
2016Co-Authors: Kenneth A. Jamerson, George L Bakris, Bertram Pitt, Eric J Velazquez, Roxzana Y Kelly, Allen Hester, Richard Devereux, Matthew Weir, Tsushung A. Hua, Michael A WeberAbstract:Abstract—The combination of Benazepril plus amlodipine was shown to be more effective than Benazepril plus hydrochlorothiazide in reducing cardiovascular events in the Avoiding Cardiovascular Events through Combination Therapy in Patients Living with Systolic Hypertension (ACCOMPLISH) trial. There was a small difference in clinic systolic blood pressure between the treatment arms favoring Benazepril plus amlodipine. Ambulatory blood pressure monitoring provides a more rigorous estimate of blood pressure effects. A subset of 573 subjects underwent ambulatory blood pressure monitoring during year 2. Readings were obtained every 20 minutes during a 24-hour period. Between-treatment differences (Benazepril plus amlodipine versus Benazepril plus hydrochlorothiazide) in mean values were analyzed using ANOVA. Treatment comparisons with respect to categorical variables were made using Pearson’s 2. At year 2, the treatment groups did not differ significantly in 24-hour mean daytime or nighttime blood pressures (values of 123.9, 125.9, and 118.1 mm Hg for Benazepril plus amlodipine group versus 122.3, 124.1, and 116.9 for the Benazepril plus hydrochlorothiazide group), with mean between-group differences of 1.6, 1.8, and 1.2 mm Hg, respectively. Blood pressure control rates (24-hour mean systolic blood pressure 130 mm Hg on ambulatory blood pressure monitoring) were greater than 80 % in both groups. Nighttime systolic blood pressure provided additional risk prediction after adjusting for the effects of drugs. The 24-hour blood pressure control was similar in both treatment arms, supporting the interpretation that the difference in cardiovascular outcomes favoring a renin angiotensin system blocke
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Efficacy and Duration of Benazepril Plus Amlodipine or Hydrochlorthiazide on 24-Hour Ambulatory Systolic Blood Pressure Control
2016Co-Authors: Kenneth A. Jamerson, George L Bakris, Bertram Pitt, Eric J Velazquez, Roxzana Y Kelly, Allen Hester, Richard Devereux, Matthew Weir, Tsushung A. Hua, Michael A WeberAbstract:Abstract—The combination of Benazepril plus amlodipine was shown to be more effective than Benazepril plus hydrochlorothiazide in reducing cardiovascular events in the Avoiding Cardiovascular Events through Combination Therapy in Patients Living with Systolic Hypertension (ACCOMPLISH) trial. There was a small difference in clinic systolic blood pressure between the treatment arms favoring Benazepril plus amlodipine. Ambulatory blood pressure monitoring provides a more rigorous estimate of blood pressure effects. A subset of 573 subjects underwent ambulatory blood pressure monitoring during year 2. Readings were obtained every 20 minutes during a 24-hour period. Between-treatment differences (Benazepril plus amlodipine versus Benazepril plus hydrochlorothiazide) in mean values were analyzed using ANOVA. Treatment comparisons with respect to categorical variables were made using Pearson’s 2. At year 2, the treatment groups did not differ significantly in 24-hour mean daytime or nighttime blood pressures (values of 123.9, 125.9, and 118.1 mm Hg for Benazepril plus amlodipine group versus 122.3, 124.1, and 116.9 for the Benazepril plus hydrochlorothiazide group), with mean between-group differences of 1.6, 1.8, and 1.2 mm Hg, respectively. Blood pressure control rates (24-hour mean systolic blood pressure 130 mm Hg on ambulatory blood pressure monitoring) were greater than 80 % in both groups. Nighttime systolic blood pressure provided additional risk prediction after adjusting for the effects of drugs. The 24-hour blood pressure control was similar in both treatment arms, supporting the interpretation that the difference in cardiovascular outcomes favoring a renin angiotensin system blocke
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predictors of systolic bp 140 mmhg and systolic bp level by randomly assigned treatment group Benazepril plus amlodipine or hydrochlorothiazide in the accomplish study
Blood Pressure, 2012Co-Authors: Sverre E Kjeldsen, George L Bakris, Bjorn Dahlof, Bertram Pitt, Kenneth Jamerson, Eric J Velazquez, Roxzana Y Kelly, Tsushung A. Hua, Dion H Zappe, Allen HesterAbstract:AbstractBackground. The ACCOMPLISH Trial investigated intensive antihypertensive combination treatment with Benazepril + amlodipine (B+A) or Benazepril + hydrochlorothiazide (B+H) on cardiovascular outcomes in patients with systolic hypertension. We analyzed the baseline predictors of achieving a systolic blood pressure (SBP) Nordic region) and Caucasian ethn...
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efficacy and duration of Benazepril plus amlodipine or hydrochlorthiazide on 24 hour ambulatory systolic blood pressure control
Hypertension, 2011Co-Authors: Kenneth Jamerson, George L Bakris, Matthew R Weir, Bjorn Dahlof, Bertram Pitt, Eric J Velazquez, Roxzana Y Kelly, Tsushung A. Hua, Richard B Devereux, Allen HesterAbstract:The combination of Benazepril plus amlodipine was shown to be more effective than Benazepril plus hydrochlorothiazide in reducing cardiovascular events in the Avoiding Cardiovascular Events through Combination Therapy in Patients Living with Systolic Hypertension (ACCOMPLISH) trial. There was a small difference in clinic systolic blood pressure between the treatment arms favoring Benazepril plus amlodipine. Ambulatory blood pressure monitoring provides a more rigorous estimate of blood pressure effects. A subset of 573 subjects underwent ambulatory blood pressure monitoring during year 2. Readings were obtained every 20 minutes during a 24-hour period. Between-treatment differences (Benazepril plus amlodipine versus Benazepril plus hydrochlorothiazide) in mean values were analyzed using ANOVA. Treatment comparisons with respect to categorical variables were made using Pearson's χ². At year 2, the treatment groups did not differ significantly in 24-hour mean daytime or nighttime blood pressures (values of 123.9, 125.9, and 118.1 mm Hg for Benazepril plus amlodipine group versus 122.3, 124.1, and 116.9 for the Benazepril plus hydrochlorothiazide group), with mean between-group differences of 1.6, 1.8, and 1.2 mm Hg, respectively. Blood pressure control rates (24-hour mean systolic blood pressure <130 mm Hg on ambulatory blood pressure monitoring) were greater than 80% in both groups. Nighttime systolic blood pressure provided additional risk prediction after adjusting for the effects of drugs. The 24-hour blood pressure control was similar in both treatment arms, supporting the interpretation that the difference in cardiovascular outcomes favoring a renin angiotensin system blocker combined with amlodipine rather than hydrochlorothiazide shown in the ACCOMPLISH trial was not caused by differences in blood pressure, but instead intrinsic properties (metabolic or hemodynamic) of the combination therapies.
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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
The Lancet, 2010Co-Authors: George L Bakris, Pantelis A Sarafidis, Matthew R Weir, Bjorn Dahlof, Bertram Pitt, Kenneth Jamerson, Eric J Velazquez, Linda Staikosbyrne, Roxzana Y Kelly, Yann Tong ChiangAbstract:Summary Background The Avoiding Cardiovascular Events through Combination Therapy in Patients Living with Systolic Hypertension (ACCOMPLISH) trial showed that initial antihypertensive therapy with Benazepril plus amlodipine was superior to Benazepril plus hydrochlorothiazide in reducing cardiovascular morbidity and mortality. We assessed the effects of these drug combinations on progression of chronic kidney disease. Methods ACCOMPLISH was a double-blind, randomised trial undertaken in five countries (USA, Sweden, Norway, Denmark, and Finland). 11 506 patients with hypertension who were at high risk for cardiovascular events were randomly assigned via a central, telephone-based interactive voice response system in a 1:1 ratio to receive Benazepril (20 mg) plus amlodipine (5 mg; n=5744) or Benazepril (20 mg) plus hydrochlorothiazide (12·5 mg; n=5762), orally once daily. Drug doses were force-titrated for patients to attain recommended blood pressure goals. Progression of chronic kidney disease, a prespecified endpoint, was defined as doubling of serum creatinine concentration or end-stage renal disease (estimated glomerular filtration rate 2 or need for dialysis). Analysis was by intention to treat (ITT). This trial is registered with ClinicalTrials.gov, number NCT00170950. Findings The trial was terminated early (mean follow-up 2·9 years [SD 0·4]) because of superior efficacy of Benazepril plus amlodipine compared with Benazepril plus hydrochlorothiazide. At trial completion, vital status was not known for 143 (1%) patients who were lost to follow-up (Benazepril plus amlodipine, n=70; Benazepril plus hydrochlorothiazide, n=73). All randomised patients were included in the ITT analysis. There were 113 (2·0%) events of chronic kidney disease progression in the Benazepril plus amlodipine group compared with 215 (3·7%) in the Benazepril plus hydrochlorothiazide group (HR 0·52, 0·41–0·65, p Interpretation Initial antihypertensive treatment with Benazepril plus amlodipine should be considered in preference to Benazepril plus hydrochlorothiazide since it slows progression of nephropathy to a greater extent. Funding Novartis.
Jonathan N. King - One of the best experts on this subject based on the ideXlab platform.
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evaluation of Benazepril in cats with heart disease in a prospective randomized blinded placebo controlled clinical trial
Journal of Veterinary Internal Medicine, 2019Co-Authors: Jonathan N. King, Wolfgang Seewald, Simon Swift, Gunther Strehlau, Mike Martin, Valerie Chetboul, L Ferasin, Anne French, Sarah G W Smith, Susan L RobertsAbstract:Background Heart disease is an important cause of morbidity and mortality in cats, but there is limited evidence of the benefit of any medication. Hypothesis The angiotensin-converting enzyme inhibitor Benazepril would delay the time to treatment failure in cats with heart disease of various etiologies. Animals One hundred fifty-one client-owned cats. Methods Cats with heart disease, confirmed by echocardiography, with or without clinical signs of congestive heart failure, were recruited between 2002 and 2005 and randomized to Benazepril or placebo in a prospective, multicenter, parallel-group, blinded clinical trial. Benazepril (0.5-1.0 mg/kg) or placebo was administered PO once daily for up to 2 years. The primary endpoint was treatment failure. Analyses were conducted separately for all-cause treatment failure (main analysis) and heart disease-related treatment failure (supportive analysis). Results No benefit of Benazepril versus placebo was detected for time to all-cause treatment failure (P = .42) or time to treatment failure related to heart disease (P = .21). Hazard ratios (95% confidence interval [CI]) from multivariate analysis for Benazepril compared with placebo were 1.00 (0.57-1.74) for all-cause failure, and 0.99 (0.50-1.94) for forward selection and 0.93 (0.48-1.81) for bidirectional selection models for heart disease-related failure. There were no significant differences between groups over time after administration of the test articles in left atrium diameter, left ventricle wall thickness, quality of life scores, adverse events, or plasma biochemistry or hematology variables. Conclusions and clinical relevance Benazepril was tolerated well in cats with heart disease, but no evidence of benefit was detected.
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Evaluation of Benazepril in cats with heart disease in a prospective, randomized, blinded, placebo‐controlled clinical trial
Journal of Veterinary Internal Medicine, 2019Co-Authors: Jonathan N. King, Wolfgang Seewald, Gunther Strehlau, Mike Martin, Valerie Chetboul, L Ferasin, Sarah G W Smith, Anne T. French, Simon T. Swift, Susan L RobertsAbstract:Background:Heart disease is an important cause of morbidity and mortality in cats,but there is limited evidence of the benefit of any medication. Hypothesis:The angiotensin-converting enzyme inhibitor Benazepril would delaythe time to treatment failure in cats with heart disease of various etiologies. Animals:One hundred fifty-one client-owned cats . Methods:Cats with heart disease, confirmed by echocardiography, with or withoutclinical signs of congestive heart failure, were recruited between 2002 and 2005and randomized to Benazepril or placebo in a prospective, multicenter, parallel-group, blinded clinical trial. Benazepril (0.5-1.0 mg/kg) or placebo was administeredPO once daily for up to 2 years. The primary endpoint was treatment failure. Ana-lyses were conducted separately for all-cause treatment failure (main analysis) andheart disease-related treatment failure (supportive analysis). Results:No benefit of Benazepril versus placebo was detected for time to all-causetreatment failure (P= .42) or time to treatment failure related to heart disease(P= .21). Hazard ratios (95% confidence interval [CI]) from multivariate analysis forBenazepril compared with placebo were 1.00 (0.57-1.74) for all-cause failure, and0.99 (0.50-1.94) for forward selection and 0.93 (0.48-1.81) for bidirectional selec-tion models for heart disease-related failure. There were no significant differencesbetween groups over time after administration of the test articles in left atriumdiameter, left ventricle wall thickness, quality of life scores, adverse events, orplasma biochemistry or hematology variables. Conclusions and Clinical Relevance:Benazepril was tolerated well in cats withheart disease, but no evidence of benefit was detected
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effect of Benazepril and robenacoxib and their combination on glomerular filtration rate in dogs
Journal of Veterinary Pharmacology and Therapeutics, 2017Co-Authors: Alessandro Panteri, Wolfgang Seewald, Cyril Desevaux, A Kukk, Jonathan N. KingAbstract:Background Combined use of angiotensin-converting enzyme inhibitors and nonsteroidal anti-inflammatory drugs may induce acute kidney injury in humans, especially when combined with diuretics. The objective of this investigation was to evaluate the effects of Benazepril, robenacoxib and their combination in healthy cats. In each of two studies (study 1 followed by study 2), 32 healthy cats were randomised to one of four groups (n = 4 male and 4 female cats per group) in a parallel-group design. The groups received orally once daily for 7 days either placebo (control group), Benazepril, robenacoxib or Benazepril plus robenacoxib. In study 2, all groups received in addition 0.5 mg/kg furosemide twice daily by subcutaneous injection for 7 days.
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effect of Benazepril robenacoxib and their combination on glomerular filtration rate in cats
BMC Veterinary Research, 2016Co-Authors: Jonathan N. King, Wolfgang Seewald, Gabriele Friton, Alessandro Panteri, Melanie Graille, Cyril DesevauxAbstract:Combined use of angiotensin-converting enzyme inhibitors and nonsteroidal anti-inflammatory drugs may induce acute kidney injury in humans, especially when combined with diuretics. The objective of this investigation was to evaluate the effects of Benazepril, robenacoxib and their combination in healthy cats. In each of two studies (study 1 followed by study 2), 32 healthy cats were randomised to one of four groups (n = 4 male and 4 female cats per group) in a parallel-group design. The groups received orally once daily for 7 days either placebo (control group), Benazepril, robenacoxib or Benazepril plus robenacoxib. In study 2, all groups received in addition 0.5 mg/kg furosemide twice daily by subcutaneous injection for 7 days. Benazepril, robenacoxib and their combination were well tolerated as evidenced from lack of clinical signs and no negative effects on body weight, feed consumption and clinical chemistry, haematology and urinalysis variables. The primary endpoint of the study was the glomerular filtration rate (GFR), which was estimated from the plasma clearance of iohexol. In the absence of furosemide, GFR was significantly higher in cats receiving the combination of Benazepril plus robenacoxib compared to the other three groups, and was also significantly higher in females receiving only Benazepril compared to the control. Administration of furosemide induced diuresis, reduced GFR and activated the renin-aldosterone-angiotensin system, evidenced from increased plasma renin activity and plasma aldosterone concentrations. Compared to the control group in cats treated with furosemide, GFR was increased by Benazepril (females only) but decreased by robenacoxib (males only). Benazepril, robenacoxib and their combination significantly inhibited the increase in plasma aldosterone induced by furosemide. The combination of Benazepril and robenacoxib was well tolerated and either increased or had a neutral effect on GFR in healthy cats without or with concomitant furosemide. The combination of Benazepril and robenacoxib reduced plasma aldosterone concentrations increased by furosemide. It is recommended to test the efficacy and safety of the combined use of Benazepril and robenacoxib in cats with clinical disease, notably proteinuric chronic kidney disease.
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tolerability and efficacy of Benazepril in cats with chronic kidney disease
Journal of Veterinary Internal Medicine, 2006Co-Authors: Jonathan N. King, Danielle Gunnmoore, Severine Tasker, Ailison Gleadhill, Gunther StrehlauAbstract:The objective of the study was to test the effect of the angiotensin-converting enzyme inhibitor (ACEI) Benazepril in cats with chronic kidney disease (CKD). A total of 192 cats with CKD with an initial plasma creatinine concentration > or = 2 mg/dL (> or = 177 micromol/L) and urine specific gravity or = 1 were 402 +/- 202 days with Benazepril and 149 +/- 90 days with placebo (P = .27). Cats with initial UPC > or = 1 treated with Benazepril had better appetite (P = .017) as compared with those treated with placebo. Benazepril was well tolerated. In conclusion, Benazepril decreased proteinuria in cats with CKD.
Robert Glazer - One of the best experts on this subject based on the ideXlab platform.
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once daily treatment of patients with hypertension a placebo controlled study of amlodipine and Benazepril vs amlodipine or Benazepril alone
Journal of Human Hypertension, 2001Co-Authors: J Pool, Suzanne Oparil, P Kaihlanen, G Lewis, D Ginsberg, Robert Glazer, F H MesserliAbstract:Objective: To compare the efficacy, tolerability, and safety of once-daily therapy with amlodipine 5 mg/Benazepril 10 mg vs amlodipine 5 mg, Benazepril 10 mg, and placebo. Design: Randomised, double-blind, placebo-controlled, parallel-group, multicentre trial. Setting: Twenty-two clinical centres, including private practice groups and academic research clinics. Patients: A total of 530 patients between 21 and 80 years of age with essential hypertension were screened for the study, and 454 were randomised to treatment with amlodipine 5 mg/Benazepril 10 mg, amlodipine 5 mg, Benazepril 10 mg, or placebo for 8 weeks. Results: Amlodipine 5 mg/Benazepril 10 mg produced greater reductions from baseline in sitting diastolic blood pressure than amlodipine 5 mg (P < 0.03), Benazepril 10 mg (P < 0.001), and placebo (P < 0.001). The response rate in the amlodipine 5-mg/Benazepril 10-mg treatment group (66.4%) was better than that observed in the amlodipine 5-mg (50.0% P < 0.02), Benazepril 10-mg (38.3% P < 0.001), and placebo (24.4% P < 0.001) groups. There was no significant difference in heart rate among the four groups. The incidence of oedema in the amlodipine 5-mg/Benazepril 10-mg (1.7%) group was somewhat less than that in the amlodipine 5-mg (4.5%) group. Conclusions: Therapy with amlodipine 5 mg/Benazepril 10 mg was well tolerated and was superior to amlodipine 5 mg, Benazepril 10 mg, and placebo in reducing sitting diastolic blood pressure in patients with essential hypertension.
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treatment of patients with essential hypertension amlodipine 5 mg Benazepril 20 mg compared with amlodipine 5 mg Benazepril 20 mg and placebo
Clinical Therapeutics, 1996Co-Authors: Emilio Kuschnir, Enzo Acuna, David Sevilla, Jesus Vasquez, Mario Bendersky, Jorge Resk, Robert GlazerAbstract:This multicenter, double-masked, randomized, parallel-group study compared the efficacy, tolerability, and safety of amlodipine 5 mg/Benazepril 20 mg, amlodipine 5 mg, Benazepril 20 mg, and placebo in patients with essential hypertension. After a placebo run-in period, 308 patients (all white) were randomized to treatment groups and took medication once daily for 8 weeks. Blood pressure was measured after 4 and 8 weeks of treatment in the 23- to 26-hour period after dosing. Patients wore a noninvasive blood pressure monitor for 24 hours before randomization and before the final visit. Investigators recorded adverse experiences at randomization and at study weeks 4 and 8, and obtained specimens for laboratory testing at randomization and at study week 8. Three hundred seven patients were evaluated for efficacy, and 308 for tolerability and safety. At end point (the last postrandomization measurement for each patient), the reduction in mean sitting diastolic blood pressure with the amlodipine 5 mg/Benazepril 20 mg treatment was statistically significantly greater than with any comparative therapy. The results of 24-hour monitoring showed that the amlodipine/Benazepril treatment, unlike monotherapy, maintained the hourly mean diastolic blood pressure at < or = 90 mm Hg. A responder rate of 87.0% was observed with amlodipine 5 mg/Benazepril 20 mg versus 67.5%, 53.3%, and 15.8% with amlodipine, Benazepril, and placebo, respectively. This difference between the amlodipine/Benazepril treatment group and each comparative single-agent treatment group was statistically significant. Drug-related adverse events occurred in 15.6% of patients in the amlodipine/Benazepril group and in 24.7%, 6.5%, and 11.7% of patients in the amlodipine, Benazepril, and placebo groups, respectively. Edema occurred less often in the amlodipine/Benazepril group than in the amlodipine group. Overall, once-daily therapy with amlodipine 5 mg/Benazepril 20 mg provided an antihypertensive effect that was statistically and clinically superior to amlodipine 5 mg alone, Benazepril 20 mg alone, and placebo, was well tolerated, and was associated with less edema than the amlodipine treatment.
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effects of Benazepril and hydrochlorothiazide given alone and in low and high dose combinations on blood pressure in patients with hypertension
Archives of Family Medicine, 1996Co-Authors: Steven G Chrysant, Robert Glazer, Timothy Fagan, Audrey KriegmanAbstract:OBJECTIVE: To assess the efficacy and safety of several combinations of Benazepril, an angiotensin-converting enzyme inhibitor, and hydrochlorothiazide, as compared with placebo, in the treatment of patients with essential hypertension. DESIGN: A 6-week, randomized, double-blind, parallel study conducted at 24 centers. A placebo run-in period of 1 to 4 weeks preceded the double-blind phase. PARTICIPANTS AND SETTING: Male and female outpatients, aged 18 years and older, were eligible to participate if their sitting diastolic blood pressure was between 95 and 114 mm Hg at the last two consecutive visits during the placebo phase. Among the 334 patients who entered the double-blind phase, 17% were aged 65 years or older and 26% were black. Eleven patients withdrew because of adverse experiences, including two patients receiving placebo. INTERVENTIONS: Patients received placebo; Benazepril, 20 mg; hydrochlorothiazide, 25 mg; or combination therapy with Benazepril/hydrochlorothiazide, 5/6.25 mg, 10/12.5 mg, 20/25 mg, 20/6.25 mg, or 5/25 mg, once daily for 6 weeks. MAIN OUTCOME MEASURES: The mean change from baseline in sitting diastolic blood pressure at end point (last postrandomization measurement carried forward) in the double-blind phase. Combination therapy with Benazepril/hydrochlorothiazide, 20/25 mg, was compared with Benazepril, 20 mg alone, and hydrochlorothiazide, 25 mg alone. Sitting systolic blood pressure and the effect of race and age on treatment efficacy were also evaluated. RESULTS: Compared with placebo, all Benazepril/hydrochlorothiazide combinations produced statistically significant reductions from baseline in sitting diastolic and systolic blood pressures at study end point. In the Benazepril/hydrochlorothiazide, 20/25 mg, group, the adjusted mean changes in sitting diastolic blood pressure at end point were statistically significantly greater than those in the monotherapy treatment groups (Benazepril, 20 mg, P < or = .05; hydrochlorothiazide, 25 mg, P < or = .001) alone. All therapies were generally well tolerated. Decreases in mean serum potassium level with hydrochlorothiazide monotherapy were reduced or eliminated with combination therapy. CONCLUSION: Benazepril in combination with hydrochlorothiazide, including a low-dose combination of 5/6.25 mg, is effective in reducing sitting diastolic and systolic blood pressure in patients with hypertension.
Michael A Weber - One of the best experts on this subject based on the ideXlab platform.
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cardiovascular benefits of angiotensin converting enzyme inhibition plus calcium channel blockade in patients achieving tight blood pressure control and with resistant hypertension
American Journal of Hypertension, 2020Co-Authors: Robert D Brook, Bjorn Dahlof, Kenneth Jamerson, Eric J Velazquez, Michael A Weber, Niko Kaciroti, George Bakris, Bertrtam Pitt, Accomplish InvestigatorsAbstract:BACKGROUND The 2017 hypertension guidelines lowered systolic blood pressure goals to <130 mm Hg and re-defined resistant hypertension. We investigated if these changes alter the cardiovascular benefits demonstrated by combining a calcium channel blocker, rather than hydrochlorthiazide, with an angiotensin converting enzyme inhibitor. METHODS In this post hoc analysis of the ACCOMPLISH trial (n=11,506), we compared the primary composite outcome (cardiovascular death, myocardial infarction, stroke, hospitalization for angina, resuscitation after sudden cardiac death, and coronary revascularization) between the 2 combination-treatment limbs in patients achieving a systolic blood pressure ≤130 mm Hg and those with "apparent resistant hypertension" (prescribed ≥4 antihypertensive medications). RESULTS Among study patients, 5221 (45.4%) achieved a systolic blood pressure ≤130 mm Hg. There were fewer primary endpoints in the amlodipine/Benazepril (9.2%) versus the hydrochlorothiazide/Benazepril (10.9%) limb (adjusted hazard ratio 0.83; 95% confidence interval, 0.70 to 0.99). There were also fewer primary endpoints in the amlodipine/Benazepril (12.8%) versus the hydrochlorothiazide/Benazepril (15.2%) limb (n=4451, 38.7%) among patients with apparent resistant hypertension (hazard ratio 0.81, 95% confidence interval, 0.70-0.95). Most individual outcomes did not significantly differ between treatment limbs, given reduced power, but many trended to favor amlodipine/Benazepril. CONCLUSIONS Combination therapy adding a calcium channel blocker, rather than hydrochlorothiazide, to an angiotensin converting enzyme inhibitor was more effective in preventing composite cardiovascular events even in hypertensive patients achieving aggressive systolic blood pressure targets as well as in those with apparent resistant hypertension. Our findings add support that most patients, including those following contemporary clinical guidelines, will benefit from this combination. TRIAL REGISTRATION ClinicalTrials.gov, NCT00170950.
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Clinical Trial Efficacy and Duration of Benazepril Plus Amlodipine or Hydrochlorthiazide on 24-Hour Ambulatory Systolic Blood Pressure Control
2016Co-Authors: Kenneth A. Jamerson, George L Bakris, Bertram Pitt, Eric J Velazquez, Roxzana Y Kelly, Allen Hester, Richard Devereux, Matthew Weir, Tsushung A. Hua, Michael A WeberAbstract:Abstract—The combination of Benazepril plus amlodipine was shown to be more effective than Benazepril plus hydrochlorothiazide in reducing cardiovascular events in the Avoiding Cardiovascular Events through Combination Therapy in Patients Living with Systolic Hypertension (ACCOMPLISH) trial. There was a small difference in clinic systolic blood pressure between the treatment arms favoring Benazepril plus amlodipine. Ambulatory blood pressure monitoring provides a more rigorous estimate of blood pressure effects. A subset of 573 subjects underwent ambulatory blood pressure monitoring during year 2. Readings were obtained every 20 minutes during a 24-hour period. Between-treatment differences (Benazepril plus amlodipine versus Benazepril plus hydrochlorothiazide) in mean values were analyzed using ANOVA. Treatment comparisons with respect to categorical variables were made using Pearson’s 2. At year 2, the treatment groups did not differ significantly in 24-hour mean daytime or nighttime blood pressures (values of 123.9, 125.9, and 118.1 mm Hg for Benazepril plus amlodipine group versus 122.3, 124.1, and 116.9 for the Benazepril plus hydrochlorothiazide group), with mean between-group differences of 1.6, 1.8, and 1.2 mm Hg, respectively. Blood pressure control rates (24-hour mean systolic blood pressure 130 mm Hg on ambulatory blood pressure monitoring) were greater than 80 % in both groups. Nighttime systolic blood pressure provided additional risk prediction after adjusting for the effects of drugs. The 24-hour blood pressure control was similar in both treatment arms, supporting the interpretation that the difference in cardiovascular outcomes favoring a renin angiotensin system blocke
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Efficacy and Duration of Benazepril Plus Amlodipine or Hydrochlorthiazide on 24-Hour Ambulatory Systolic Blood Pressure Control
2016Co-Authors: Kenneth A. Jamerson, George L Bakris, Bertram Pitt, Eric J Velazquez, Roxzana Y Kelly, Allen Hester, Richard Devereux, Matthew Weir, Tsushung A. Hua, Michael A WeberAbstract:Abstract—The combination of Benazepril plus amlodipine was shown to be more effective than Benazepril plus hydrochlorothiazide in reducing cardiovascular events in the Avoiding Cardiovascular Events through Combination Therapy in Patients Living with Systolic Hypertension (ACCOMPLISH) trial. There was a small difference in clinic systolic blood pressure between the treatment arms favoring Benazepril plus amlodipine. Ambulatory blood pressure monitoring provides a more rigorous estimate of blood pressure effects. A subset of 573 subjects underwent ambulatory blood pressure monitoring during year 2. Readings were obtained every 20 minutes during a 24-hour period. Between-treatment differences (Benazepril plus amlodipine versus Benazepril plus hydrochlorothiazide) in mean values were analyzed using ANOVA. Treatment comparisons with respect to categorical variables were made using Pearson’s 2. At year 2, the treatment groups did not differ significantly in 24-hour mean daytime or nighttime blood pressures (values of 123.9, 125.9, and 118.1 mm Hg for Benazepril plus amlodipine group versus 122.3, 124.1, and 116.9 for the Benazepril plus hydrochlorothiazide group), with mean between-group differences of 1.6, 1.8, and 1.2 mm Hg, respectively. Blood pressure control rates (24-hour mean systolic blood pressure 130 mm Hg on ambulatory blood pressure monitoring) were greater than 80 % in both groups. Nighttime systolic blood pressure provided additional risk prediction after adjusting for the effects of drugs. The 24-hour blood pressure control was similar in both treatment arms, supporting the interpretation that the difference in cardiovascular outcomes favoring a renin angiotensin system blocke
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Effect of Antihypertensive Monotherapy and Combination Therapy on Arterial Distensibility and Left Ventricular Mass
2016Co-Authors: Joel M. Neutel, David H. G. Smith, Michael A WeberAbstract:inhibitors and calcium channel blockers (CCBs) increase arterial compliance and decrease left ventricular mass in hypertensive patients. This study examined whether com-bined therapy has greater arterial and cardiac effects than doubled doses of the individual drugs. Methods: This prospective, randomized, open-label study enrolled 106 patients aged 18 years with mild-to-moderate hypertension. Patients were randomized to 5 mg of amlodipine or 20 mg of Benazepril for 2 weeks; then, depending on randomization assignment, they were force-titrated to 10 mg of amlodipine or 40 mg of Benazepril monotherapy, or to combination amlodipine (5 mg) and Benazepril (20 mg) treatment for 22 weeks. Arterial dis-tensibility was assessed using the DynaPulse ambulatory system, and left ventricular mass was assessed by echo-cardiography. Results: Combination therapy (0.71 % 0.51% mL/mm Hg) increased arterial distensibility more tha
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Benazepril plus amlodipine or hydrochlorothiazide for hypertension in high risk patients
The New England Journal of Medicine, 2008Co-Authors: Kenneth Jamerson, George L Bakris, Bjorn Dahlof, Bertram Pitt, Michael A Weber, Victor Shi, Allen Hester, Jitendra Gupte, Marjorie Regan Gatlin, Eric J VelazquezAbstract:Background The optimal combination drug therapy for hypertension is not established, although current U.S. guidelines recommend inclusion of a diuretic. We hypothesized that treatment with the combination of an angiotensin-converting–enzyme (ACE) inhibitor and a dihydropyridine calcium-channel blocker would be more effective in reducing the rate of cardiovascular events than treatment with an ACE inhibitor plus a thiazide diuretic. Methods In a randomized, double-blind trial, we assigned 11,506 patients with hypertension who were at high risk for cardiovascular events to receive treatment with either Benazepril plus amlodipine or Benazepril plus hydrochlorothiazide. The primary end point was the composite of death from cardiovascular causes, nonfatal myocardial infarction, nonfatal stroke, hospitalization for angina, resuscitation after sudden cardiac arrest, and coronary revascularization. Results The baseline characteristics of the two groups were similar. The trial was terminated early after a mean follow-up of 36 months, when the boundary of the prespecified stopping rule was exceeded. Mean blood pressures after dose adjustment were 131.6/73.3 mm Hg in the Benazepril–amlodipine group and 132.5/74.4 mm Hg in the Benazepril–hydrochlorothiazide group. There were 552 primary-outcome events in the Benazepril–amlodipine group (9.6%) and 679 in the Benazepril–hydrochlorothiazide group (11.8%), representing an absolute risk reduction with Benazepril–amlodipine therapy of 2.2% and a relative risk reduction of 19.6% (hazard ratio, 0.80, 95% confidence interval [CI], 0.72 to 0.90; P<0.001). For the secondary end point of death from cardiovascular causes, nonfatal myocardial infarction, and nonfatal stroke, the hazard ratio was 0.79 (95% CI, 0.67 to 0.92; P = 0.002). Rates of adverse events were consistent with those observed from clinical experience with the study drugs. Conclusions The Benazepril–amlodipine combination was superior to the Benazepril–hydrochlorothiazide combination in reducing cardiovascular events in patients with hypertension who were at high risk for such events. (ClinicalTrials.gov number, NCT00170950.)
Susan L Roberts - One of the best experts on this subject based on the ideXlab platform.
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evaluation of Benazepril in cats with heart disease in a prospective randomized blinded placebo controlled clinical trial
Journal of Veterinary Internal Medicine, 2019Co-Authors: Jonathan N. King, Wolfgang Seewald, Simon Swift, Gunther Strehlau, Mike Martin, Valerie Chetboul, L Ferasin, Anne French, Sarah G W Smith, Susan L RobertsAbstract:Background Heart disease is an important cause of morbidity and mortality in cats, but there is limited evidence of the benefit of any medication. Hypothesis The angiotensin-converting enzyme inhibitor Benazepril would delay the time to treatment failure in cats with heart disease of various etiologies. Animals One hundred fifty-one client-owned cats. Methods Cats with heart disease, confirmed by echocardiography, with or without clinical signs of congestive heart failure, were recruited between 2002 and 2005 and randomized to Benazepril or placebo in a prospective, multicenter, parallel-group, blinded clinical trial. Benazepril (0.5-1.0 mg/kg) or placebo was administered PO once daily for up to 2 years. The primary endpoint was treatment failure. Analyses were conducted separately for all-cause treatment failure (main analysis) and heart disease-related treatment failure (supportive analysis). Results No benefit of Benazepril versus placebo was detected for time to all-cause treatment failure (P = .42) or time to treatment failure related to heart disease (P = .21). Hazard ratios (95% confidence interval [CI]) from multivariate analysis for Benazepril compared with placebo were 1.00 (0.57-1.74) for all-cause failure, and 0.99 (0.50-1.94) for forward selection and 0.93 (0.48-1.81) for bidirectional selection models for heart disease-related failure. There were no significant differences between groups over time after administration of the test articles in left atrium diameter, left ventricle wall thickness, quality of life scores, adverse events, or plasma biochemistry or hematology variables. Conclusions and clinical relevance Benazepril was tolerated well in cats with heart disease, but no evidence of benefit was detected.
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Evaluation of Benazepril in cats with heart disease in a prospective, randomized, blinded, placebo‐controlled clinical trial
Journal of Veterinary Internal Medicine, 2019Co-Authors: Jonathan N. King, Wolfgang Seewald, Gunther Strehlau, Mike Martin, Valerie Chetboul, L Ferasin, Sarah G W Smith, Anne T. French, Simon T. Swift, Susan L RobertsAbstract:Background:Heart disease is an important cause of morbidity and mortality in cats,but there is limited evidence of the benefit of any medication. Hypothesis:The angiotensin-converting enzyme inhibitor Benazepril would delaythe time to treatment failure in cats with heart disease of various etiologies. Animals:One hundred fifty-one client-owned cats . Methods:Cats with heart disease, confirmed by echocardiography, with or withoutclinical signs of congestive heart failure, were recruited between 2002 and 2005and randomized to Benazepril or placebo in a prospective, multicenter, parallel-group, blinded clinical trial. Benazepril (0.5-1.0 mg/kg) or placebo was administeredPO once daily for up to 2 years. The primary endpoint was treatment failure. Ana-lyses were conducted separately for all-cause treatment failure (main analysis) andheart disease-related treatment failure (supportive analysis). Results:No benefit of Benazepril versus placebo was detected for time to all-causetreatment failure (P= .42) or time to treatment failure related to heart disease(P= .21). Hazard ratios (95% confidence interval [CI]) from multivariate analysis forBenazepril compared with placebo were 1.00 (0.57-1.74) for all-cause failure, and0.99 (0.50-1.94) for forward selection and 0.93 (0.48-1.81) for bidirectional selec-tion models for heart disease-related failure. There were no significant differencesbetween groups over time after administration of the test articles in left atriumdiameter, left ventricle wall thickness, quality of life scores, adverse events, orplasma biochemistry or hematology variables. Conclusions and Clinical Relevance:Benazepril was tolerated well in cats withheart disease, but no evidence of benefit was detected