Lotrel outdoes Lotensin/HCTZ in ACCOMPLISH

This was a high risk population of hypertensives. The study was published in NEJM. Despite nearly identical BP control, outcomes were better in the Lotrel 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).

In a Medscape piece concerning the study Dr Franz Messerli commented:

"This landmark study unequivocally relegates hydrochlorothiazide from first-line to third-line therapy at least in a patient population with similar demographic and clinical features as in ACCOMPLISH," said Messerli. "The issue is not to be taken lightly, since hydrochlorothiazide remains one of the most commonly prescribed antihypertensive drugs….”