Initial combination therapy for treatment of hypertension/Authors' reply

[...] the ACCOMPLISH trial4 found that, in high-risk patients with hypertension, benazepril plus amlodipine was superior to benazepril plus hydro chlorothiazide in reducing blood pressure and cardiovascular events. Since benazepril plus amlodipine is an option to improve cardiovascular outcomes in patients with an indication for initial combination treatment, Brown and colleagues, and the sponsor of the ACCELERATE trial, should tell us why the control group of their study was not given benazepril plus amlodipine rather than aliskiren or amlodipine monotherapy. [...] no evidence is available that aliskiren plus amlodipine can reduce blood pressure and cardiovascular events at least as effectively as benazepril plus amlodipine. [...] Brown and colleagues' conclusion that the combination of aliskiren plus amlodipine can be recommended for routine initial blood pressure reduction1 is not sound.