In patients with prior history of cerebrovascular accident (CVA), the A + C + D group had a significantly higher AMI-free survival (adjusted HR = 1.56 95% CI 1.051−2.307 p < 0.05) as compared with the A + B + C group. There were no differences in the incidence of cardiovascular events between the two groups. Results: After propensity score matching, there were 5120 patients in each group. The event-free survival of stroke, acute myocardial infarction (AMI), mortality, and major adverse cardiovascular events (MACE) between the two treatment groups was investigated. The A + C + D group as patients who received ACEI/ARB, CCB, and diuretics. Patients were further classified into two treatment groups according to the medication possession ratio of drug combinations the A + B + C group as those who received concurrent therapy of ACEI/ARB, beta-blocker and CCB. Methods: A total of 13,551 patients who were concurrently receiving three anti-hypertensive agents of different classes through outpatient clinics during 2004−2006 were identified from the National Health Insurance Research Database of Taiwan. Background: In patients already receiving combination of angiotensin-converting enzyme inhibitor (ACEI)/angiotensin receptor blocker (ARB) and calcium channel blocker (CCB), whether the choice of additional diuretic or beta-blocker affects the cardiovascular and cerebrovascular outcomes remains unclear.
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