ASCOT-Blood Pressure Arm

To evaluate whether treatment with a newer antihypertensive regimen of calcium channel blocker with or without an ACE-inhibitor is more effective than an older regimen of beta-blocker with or without a diuretic reduces coronary heart disease (CHD) events in hypertensive patients with relatively low cholesterol levels.

Randomized, blinded and factorial

19,257 patients with systolic blood pressure (SBP) ≥160 mm Hg and/or diastolic blood pressure (DBP) ≥100 mm Hg (untreated) or SBP ≥140 mm Hg and/or DBP ≥90 mm Hg (treated); total cholesterol ≤250 mg/dl and triglycerides ≤400 mg/dl; age 40-79 years; ≥3 cardiovascular disease risk factors; and no history of CHD.

Amlodipine 5/10 mg with or without perindopril 4/8 mg versus atenolol 50/100 mg with or without bendroflumethiazide 1.25/5 mg

5.4 years

Nonfatal MI and fatal coronary heart disease

Among patients with hypertension and relatively low cholesterol, a strategy of treatment with amlodipine and the ACE inhibitor, perindopril if needed, was associated with reductions in many secondary endpoints, including mortality, compared with treatment with the beta-blocker, atenolol and the diuretic, bendroflumethiazide.