UMIN-CTR Clinical Trial

Unique ID issued by UMIN UMIN000002631
Receipt number R000003205
Scientific Title Prospective, randomized, open-label, clinical trial comparing the effects of olmesartan and amlodipine on blood pressure, endothelial function and makers for obesity/oxidative stress/chronic kidney diseases
Date of disclosure of the study information 2009/10/16
Last modified on 2011/12/01 13:30:19

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Basic information

Public title

Prospective, randomized, open-label, clinical trial comparing the effects of olmesartan and amlodipine on blood pressure, endothelial function and makers for obesity/oxidative stress/chronic kidney diseases

Acronym

Prospective, randomized, open-label, clinical trial comparing the effects of olmesartan and amlodipine

Scientific Title

Prospective, randomized, open-label, clinical trial comparing the effects of olmesartan and amlodipine on blood pressure, endothelial function and makers for obesity/oxidative stress/chronic kidney diseases

Scientific Title:Acronym

Prospective, randomized, open-label, clinical trial comparing the effects of olmesartan and amlodipine

Region

Japan


Condition

Condition

Hypertension

Classification by specialty

Cardiology

Classification by malignancy

Others

Genomic information

NO


Objectives

Narrative objectives1

Comparison of olmesartan versus amlodipine on blood pressure, endothelial function and levels of markers for inflammation/obesity/oxidative stress/early stage kidney diseases.

Basic objectives2

Efficacy

Basic objectives -Others


Trial characteristics_1


Trial characteristics_2


Developmental phase



Assessment

Primary outcomes

Blood pressure (On visit/Home monitoring)
Flow-mediated vasodilation in forearm
Heparin-releasable EC-SOD levels
Twelve weeks after administration

Key secondary outcomes

Markers indicating obesity (e.g. adiponectin), inflammation (high sensitive CRP), oxidative stress (8-OHdG/ MDA-LDL), early-staged kidney diseases (microalbuminuria)
Twelve weeks after administration


Base

Study type

Interventional


Study design

Basic design

Cross-over

Randomization

Randomized

Randomization unit


Blinding

Open -but assessor(s) are blinded

Control

Active

Stratification


Dynamic allocation


Institution consideration


Blocking


Concealment



Intervention

No. of arms

2

Purpose of intervention

Treatment

Type of intervention

Medicine

Interventions/Control_1

Administration of olmesartan

Interventions/Control_2

Administration of amlodipine

Interventions/Control_3


Interventions/Control_4


Interventions/Control_5


Interventions/Control_6


Interventions/Control_7


Interventions/Control_8


Interventions/Control_9


Interventions/Control_10



Eligibility

Age-lower limit

20 years-old <=

Age-upper limit

75 years-old >=

Gender

Male and Female

Key inclusion criteria

1) Hypertensive patients recommended for administration of antihypertensive agents in Hypertension Guidelines issued by Japanese Association of Hypertension
2) Outpatients
3) Subjects who gave written informed consent

Key exclusion criteria

1) Allergy against olmesartan/amlodipine
2) Poor-controlled hypertension (DBP>110 mmHg)
3) Poor-controlled diabetes (HbA1c>8.0 %)
4) Secondary hypertension
5) History of stroke, acute coronary syndrome or any cardiovascular diseases needed for inpatient-treatments within 6 months
6) Either level of aspartate aminotransaminase or alanine aminotransferase exceed three-fold of the normal limits.
7) End stage renal disease
8) Symptomatic (NYHA III or IV) congestive heart failure
9) Malignancies or other diseases with poor prognosis
10) Pregnant
11) Subjects whose doctor in charge do not agree to join the trial

Target sample size

30


Research contact person

Name of lead principal investigator

1st name
Middle name
Last name Katsunori Ikewaki

Organization

National Defense Medical College

Division name

Department of Internal Medicine

Zip code


Address

3-2 Namiki, Tokorozawa Japan 359-8513

TEL


Email



Public contact

Name of contact person

1st name
Middle name
Last name Makoto Ayaori

Organization

National Defense Medical College

Division name

Department of Internal Medicine

Zip code


Address


TEL


Homepage URL


Email

ayaori@ndmc.ac.jp


Sponsor or person

Institute

National Defense Medical College

Institute

Department

Personal name



Funding Source

Organization

Foundation for Promotion of Defense Medicine

Organization

Division

Category of Funding Organization

Non profit foundation

Nationality of Funding Organization



Other related organizations

Co-sponsor


Name of secondary funder(s)



IRB Contact (For public release)

Organization


Address


Tel


Email



Secondary IDs

Secondary IDs

NO

Study ID_1


Org. issuing International ID_1


Study ID_2


Org. issuing International ID_2


IND to MHLW



Institutions

Institutions



Other administrative information

Date of disclosure of the study information

2009 Year 10 Month 16 Day


Related information

URL releasing protocol


Publication of results

Published


Result

URL related to results and publications

http://www.nature.com/hr/journal/v34/n6/full/hr201111a.html

Number of participants that the trial has enrolled


Results

Endothelial dysfunction in essential hypertension is an independent predictor for future cardiovascular events. Although inhibition of the renin-angiotensin system (RAS) reportedly improves endothelial function through its effects on oxidative stress and inflammation, questions remain regarding which factors are pivotal for improvement of endothelial function by RAS inhibition. We therefore performed a prospective, randomized crossover trial in which an angiotensin II type 1 receptor antagonist (ARB), olmesartan, and calcium channel blocker (CCB), amlodipine, were compared in 31 essential hypertensive patients. Results showed that, although both treatments achieved comparable lowering of blood pressure (BP), olmesartan, but not amlodipine, significantly improved endothelial function as evaluated by flow-mediated vasodilation (FMD) in the brachial artery. Although no significant changes in diabetic and lipid parameters were observed with either drug, olmesartan slightly decreased estimated glomerular filtration rate which, surprisingly, translated into decreased microalbuminuria. In a similar vein, olmesartan reduced serum C-reactive protein and increased urine antioxidant levels compared to baseline, and reduced urine 8-epi-prostaglandin F2alpha levels compared to both baseline and amlodipine. Finally, although overall changes in plasma extracellular superoxide dismutase (EC-SOD) levels were not modulated by either treatment, for olmesartan there was a positive correlation between changes in FMD and those in EC-SOD levels.
In conclusion, olmesartan improved endothelial function in hypertensive patients independent of its BP-lowering effect, which was due, at least in part, to its antioxidative property. Therefore, olmesartan might provide a greater long term benefit for hypertensive patients with impaired endothelial function than amlodipine.

Results date posted


Results Delayed


Results Delay Reason


Date of the first journal publication of results


Baseline Characteristics


Participant flow


Adverse events


Outcome measures


Plan to share IPD


IPD sharing Plan description



Progress

Recruitment status

Completed

Date of protocol fixation

2009 Year 10 Month 15 Day

Date of IRB


Anticipated trial start date

2009 Year 10 Month 01 Day

Last follow-up date

2011 Year 06 Month 01 Day

Date of closure to data entry

2011 Year 07 Month 01 Day

Date trial data considered complete

2011 Year 07 Month 01 Day

Date analysis concluded

2011 Year 08 Month 01 Day


Other

Other related information



Management information

Registered date

2009 Year 10 Month 15 Day

Last modified on

2011 Year 12 Month 01 Day



Link to view the page

Value
https://center6.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000003205


Research Plan
Registered date File name

Research case data specifications
Registered date File name

Research case data
Registered date File name