(February 18, 2010 - Insidermedicine)

Combining the two blood pressure-lowering drugs benazepril and amlodipine protects the kidneys better than combining benazepil with the diuretic hydrochlorothiazide, according to research published online ahead of print in The Lancet.

Here is some information about high blood pressure and kidney disease:

•    Having untreated high blood pressure makes the heart work harder, which can, over time, damage blood vessels all over the body

•    One of the places blood vessels are often damaged in those with high blood pressure is the kidneys

•    High blood pressure is a leading cause of kidney disease

Researchers from the University of Chicago representing the ACCOMPLISH study investigators randomly assigned over 11,000 patients from five countries who were suffering from high blood pressure to treatment with the gold standard of benazepril combined with hydrochlorothiazide, a drug that helps flush excess fluid from the body, or with a novel combination of benazepril plus amlodipine, a drug that uses a different mechanism to lower blood pressure. All the participants were considered to be at high risk for cardiovascular disease.

The study was stopped early, after an average follow-up period of about 3 years, because those in the benazepril/ hydrochlorothiazide were nearly twice as likely to experience progression of chronic kidney disease as those in the benazepril/amlodipine group. The rate of progression of chronic kidney disease was 2% in the benazepril/amlodipine group, versus nearly 4% in the benazepril/ hydrochlorothiazide group.

Today’s research suggests that health care professionals make a change from preferentially prescribing benazepril/ hydrochlorothiazide for high blood pressure to benazepril/amlodipine, because this second combination does a better job of protecting the kidneys.