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At the heart of general practice since 1960

BP drugs slow CKD progression

By Lilian Anekwe

GPs should consider benazepril plus amlodipine for high blood pressure, say US researchers.

A post-hoc analysis of the ACCOMPLISH study found patients with hypertension given the ACE inhibitor and cacium channel blocker were half as likely to experience progression of chronic kidney disease than those on benazepril plus hydrochlorothiazide.

Some 11,500 patients with hypertension who were at high risk for cardiovascular events were randomly assigned to either benazepril 20mg plus either amlodipine 5mg or hydrochlorothiazide 12.5mg orally once daily.

In the amlodipine group, CKD progressed in 2% of patients, compared with 3.7% in hydrochlorothiazide group.

Study leader Dr George Bakris, director of the hypertensive diseases unit at the University of Chicago school of medicine, said: ‘Initial antihypertensive treatment with benazepril plus amlodipine should be considered in preference to benazepril plus hydrochlorothiazide since it slows progression of CKD to a greater extent.

'This benefit was also seen when cardiovascular or all-cause mortality were assessed with progression of chronic kidney disease. Differences in blood pressure control throughout the study could not account for these findings.'

The Lancet, published online February 18

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