Stroke was a prespecified secondary end point occur- ring at annual rates of 0.32% (more intensive) and 0.53% (less In the Avoiding Cardiovascular Events in Combination Therapy in Patients Living with Systolic Hypertension (ACCOMPLISH) trial, 11506 patients (6746 with diabetes mellitus) with hypertension were randomized to treatment with benazepril plus amlodipine or benazepril plus hydro- The primary end point was the composite of death resulting from CVD, nonfatal MI, nonfatal stroke, hospitalization for angina, resuscitated cardiac arrest, and cor- onary revascularization. The trial was terminated early after a mean follow-up of 36 months when there were 552 primary outcome events in the benazepril/amlodipine group (9.6%) and 679 in the benazepril/hydrochlorothiazide group (11.8%), an absolute risk reduction of 2.2% (HR, 0.80; 95% CI, 0.72 0.90; P<0.001). There was, however, no difference in stroke between the groups. Of the participants in the ACCOMPLISH trial with diabetes mellitus, the primary outcome results were similar. Two recent meta-analyses investigated the effect of BP lowering in patients with type 2 diabetes mellitus. The first included 37760 patients with type 2 diabetes mellitus or impaired fasting glucose/impaired glucose tolerance with achieved SBP of 135 versus 140 mmHg, and the follow-up was at least 1 year.310 Intensive BP control was associated with a 10% reduction in all-cause mortality (OR, 0.90; 95% CI, 0.83 0.98) and a 17% reduction in stroke, but there was a 20% increase in serious adverse effects. Meta-regression analysis showed continued risk reduction for stroke to a SBP of <120 mmHg. However, at levels of <130 mmHg, there was a 40% increase in serious adverse events with no benefit for other outcomes. 