1. Effects of amlodipine plus telmisartan or amlodipine plus amiloride regimen on blood pressure control in hypertensive patients: preliminary report of Chinese Hypertension Intervention Efficacy (CHIEF) trial Wang W, Ma LY, Liu MB et al. Zhonghua Xin Xue Guan Bing Za Zhi. 2009;37:701-707.

2. Objectives of the study To evaluate blood pressure reduction with anamlodipine-based regimen (amlodipine/telmisartan and amlodipine/co- amiloride) and its impact on cardiovascular morbidity and mortality.

3. Methods 13542 hypertensive patients from 180 centers in China were followed for 4 years. All patients between 50 and 79 years of age with essential hypertension (I-II grade) At least one cardiovascular risk factor Patients randomly assigned to group A (low-dose amlodipine + co-amiloride) or group T (low-dose amlodipine + telmisartan) Primary end points : nonfatal stroke/myocardial infarction and cardiovascular death

4. Results Baseline characteristics of patients were homogeneous between the two groups: -Mean age 61.5±7.7 years old -19% history of cerebrovascular disease -12% coronary disease -18% diabetes -42% dyslipidemia -Mean initial blood pressure was 157/93 mm Hg

5. Blood pressure reduction Group A (amlodipine + co-amiloride)Group T (amlodipine + telmisartan)

6. End points Group T (temilsartan + amlodipine) Group A (Co- amiloride + amlodipine) Hazard ratios Primary end point186 (2.7)163 (2.4)1.14 Total stroke141 (2.1)127 (1.7)1.20 Nonfatal stroke130 (1.9)108 (1.6)1.20 Fatal stroke14 (0.2)12 (0.2)1.20 Total MI26 (0.4)30 (0.4)0.86 Nonfatal MI18 (0.3)24 (0.4)0.75 Fatal MI9 (0.1)6 (0.1)1.50 Cardiovascular death44 (0.7)34 (0.5)1.33 Non-ardiovascular death 36 (0.5)63 0.9)0.58 Total death80 (1.2)97 (1.4)0.84 95% CI Group T (telmisartan + amlodipine) better Group A (co-amiloride + amlodipine) 00.5 1.0 1.5 2.0

7. Conclusion Amlodipine + ARB combination is not better than amlodipine + diuretic combination in reducing cardiovascular events in patients with hypertension