Most clinicians can easily understand the results of the ACCOMPLISH trial, but w ould have difficulty applying

them to clinical practice. Questions raised by thi s study include: Should patients with well-controlled blood pressure who are cur rently on combination therapy with an ACE inhibitor/thiazide diuretic be switche d to an ACE inhibitor plus dihydropyridine calcium channel blocker? Do the resul ts of this trial change the choice for initial monotherapy for hypertension, wit h a long-acting ACE inhibitor/ARB or a long-acting dihydropyridine calcium chann el blocker being preferred so that the second class can be added if the patient responds but does not reach goal with the initial drug? Answering these question s requires an understanding of the preceding literature on therapy of hypertensi on, and expertise that most clinicians do not possess.Most clinicians can easily understand the results of the ACCOMPLISH trial, but would have difficulty apply ing them to clinical practice. Questions raised by this study include: Should pa tients with well-controlled blood pressure who are currently on combination ther apy with an ACE inhibitor/thiazide diuretic be switched to an ACE inhibitor plus dihydropyridine calcium channel blocker? Do the results of this trial change th e choice for initial monotherapy for hypertension, with a long-acting ACE inhibi tor/ARB or a long-acting dihydropyridine calcium channel blocker being preferred so that the second class can be added if the patient responds but does not reac h goal with the initial drug? Answering these questions requires an understandin g of the preceding literature on therapy of hypertension, and expertise that mos t clinicians do not possess.Most clinicians can easily understand the results of the ACCOMPLISH trial, but would have difficulty applying them to clinical pract ice. Questions raised by this study include: Should patients with well-controlle d blood pressure who are currently on combination therapy with an ACE inhibitor/ thiazide diuretic be switched to an ACE inhibitor plus dihydropyridine calcium c hannel blocker? Do the results of this trial change the choice for initial monot herapy for hypertension, with a long-acting ACE inhibitor/ARB or a long-acting d ihydropyridine calcium channel blocker being preferred so that the second class can be added if the patient responds but does not reach goal with the initial dr ug? Answering these questions requires an understanding of the preceding literat ure on therapy of hypertension, and expertise that most clinicians do not posses s.