Stroke Clinical Trial
Official title:
A Multi-Center, Double Blind, Randomized and Non-Inferiority Clinical Study of Cilnidipine to Compare the Effects on Cerebral Blood Flow With Losartan in Patients With Ischemic Stroke Hypertension
The purpose of this study is to compare the effect of cilnidipine (a calcium channel blocker) and losartan (an angiotensin II receptor blocker) on cerebral blood flow (CBF) and blood pressure in hypertensive patients with a previous ischemic stroke.
Design: Multi-center, randomized, double-blind, active control, titrated dose,
non-inferiority trial
Population Studied: We will prospectively recruit 250 hypertensive patients who had ischemic
stroke 2 or more weeks previously and were admitted at 7 centers in the Seoul metropolitan
area in South Korea.
Interventions: After a 2-week washout period, all patients will undergo baseline 99mTc-HMPAO
single photon emission computed tomography (SPECT), blood pressure evaluation, NIHSS
examination, and laboratory test prior to treatment. The patients will be randomized to
receive either cilnidipine 10-20mg or losartan 50-100mg once daily for 4 weeks with a target
systolic blood pressure of < 140mmHg and diastolic blood pressure of < 90mmHg. After 4-week
treatment, all patients will receive follow-up SPECT and blood pressure evaluation. For the
quantitative CBF analysis, SPECT will be performed with a single machine in one center.
Outcome Measures: Primary outcome measure is the percentile change of global CBF on SPECT
between pre- and post-treatments. Secondary outcome measures include the percentile change
of regional CBF, the proportion of patients less than 8.6% decrease of global CBF, and the
change of NIHSS score.
;
Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Double Blind (Subject, Caregiver, Investigator, Outcomes Assessor), Primary Purpose: Treatment
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