High-Dose Quinapril Versus Low-Dose Quinapril Plus Amlodipine in the Treatment of High-Risk Hypertensive Patients

Inclusion Criteria: Patients with a documented history of hypertension defined as: SBP > or = 140 mmHg or DBP > or = 90 mmHg if hypertension untreated or patients currently treated for hypertension. Documented CAD or diabetes or impaired glucose tolerance Sinus rhythm Principal Exclusion Criteria: Previous intolerance or allergic reaction to an ACE inhibitor, an ARB or dihydropyridine calcium channel blocker History of angioedema or cough related to previous ACE inhibitor use. Systolic blood pressure > 180 mmHg or diastolic blood pressure > 110 mmHg in untreated patients Systolic blood pressure > 160 mmHg or diastolic blood pressure > 100 mmHg in patients currently treated by an ACE inhibitor or an ARB Creatinine clearance < 30 ml/min Significant liver dysfunction Current serum potassium > or = 5 mmol/L or a history of marked ACE inhibitor or ARB induced hyperkalemia resulting in either a serum potassium > or = 5.5 mmol/L or a life-threatening adverse event. History of HF or known LVEF < or = 45% Bilateral renal artery stenosis (or unilateral if only one kidney) Unstable angina, myocardial infarction or coronary revascularization within the last 3 months. Connective tissue disease or chronic inflammatory condition Active malignancy Active infection in the last 2 weeks Inability or any contraindication to perform an exercise test.