ACCOMPLISH
Benzipril plus Amlodipine vs Benzipril plus Hydroclorothiazide
BA showed a 19% relative risk reduction of CV events when compared with BH. BA is superior for use in HTN in patients at risk of CV events.
===================================================
ACCORD (Action to Control Cardiovascular Risk in Diabetes)
AASK (African American Study of Kidney Disease) Appel LJ, Wright JT Jr, Greene T, et al; AASK Collaborative Research Group. Intensive blood-pressure control in hypertensive chronic kidney disease. N Engl J Med. 2010;363:918-929
randomly assigned 1094 black patients with hypertensive chronic kidney disease to receive either intensive or standard blood-pressure control. CONCLUSIONS: In overall analyses, intensive blood-pressure control had no effect on kidney disease progression. However, there may be differential effects of intensive blood-pressure control in patients with and those without baseline proteinuria.
we find that aggressive therapy isn't necessarily helpful except perhaps for select events, in ACCORD, it was stroke. In ASSK, it is black patients who have chronic kidney disease and protineuria (300mg/day).
aggressive therapy in this case means getting bp below 140
=========================================================
