{"id":6013,"date":"2011-01-14T11:14:45","date_gmt":"2011-01-14T16:14:45","guid":{"rendered":"http:\/\/blogs.nejm.org\/cardioexchange\/?p=6013"},"modified":"2011-07-19T17:44:38","modified_gmt":"2011-07-19T21:44:38","slug":"combination-therapy-beats-single-therapy-as-initial-antihypertensive-therapy","status":"publish","type":"post","link":"https:\/\/blogs.nejm.org\/cardioexchange\/2011\/01\/14\/combination-therapy-beats-single-therapy-as-initial-antihypertensive-therapy\/","title":{"rendered":"Combination Therapy Beats Single Therapy As Initial Antihypertensive Therapy"},"content":{"rendered":"<p>In the ACCELERATE (Aliskiren and the calcium channel blocker amlopdipine combination as an initial treatment strategy for hypertension control) trial, more than 1200 patients with early essential hypertension were randomized to either aliskiren, amlodipine, or the combination of the two drugs for 4 months. The results, which have been p<a href=\"http:\/\/www.thelancet.com\/journals\/lancet\/article\/PIIS0140-6736(10)62003-X\/fulltext\">ublished online in the Lancet<\/a>, showed that blood pressure reduction was greater by 6.5 mm Hg in the combination group than in the monotherapy groups (p&lt;0.0001). After 4 months, when all patients were switched to combination therapy, the difference between the groups had narrowed to 1.4 mm Hg (p=0.059). The investigators concluded that their results suggest that &#8220;a\u00a0move towards routine initial reduction of blood\u00a0pressure with combination therapy can now be\u00a0advocated.&#8221;<\/p>\n<p>In\u00a0<a href=\"http:\/\/www.thelancet.com\/journals\/lancet\/article\/PIIS0140-6736(10)62270-2\/fulltext\">an accompanying comment<\/a>, \u00a0Ivana Lazich and George Bakris write that &#8220;a change in guidelines is clearly necessary after the ACCELERATE report&#8221; and the previously reported ACCOMPLISH study. They recommend that &#8220;initial combination therapy should be advocated for all those already implementing lifestyle changes who are still above 150\/90 mm Hg, as most people in ACCELERATE were.&#8221;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>In the ACCELERATE (Aliskiren and the calcium channel blocker amlopdipine combination as an initial treatment strategy for hypertension control) trial, more than 1200 patients with early essential hypertension were randomized to either aliskiren, amlodipine, or the combination of the two drugs for 4 months. The results, which have been published online in the Lancet, showed [&hellip;]<\/p>\n","protected":false},"author":196,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[7],"tags":[660,661,590,662],"class_list":["post-6013","post","type-post","status-publish","format-standard","hentry","category-prevention","tag-aliskiren","tag-amlodipine","tag-antihypertensive-agents","tag-combination-therapy"],"_links":{"self":[{"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/posts\/6013","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/users\/196"}],"replies":[{"embeddable":true,"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/comments?post=6013"}],"version-history":[{"count":0,"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/posts\/6013\/revisions"}],"wp:attachment":[{"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/media?parent=6013"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/categories?post=6013"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/tags?post=6013"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}