Hypertension Clinical Trial
Official title:
Efficacy and Safety of Two Fixed-combination Antihypertensive Regimens, Amtrel® and Co-Diovan® in Type 2 Diabetes Hypertension Patients With Microalbuminuria
The purpose of the study is to compare the change from baseline in blood pressures (DBP/SBP)
to 16-week regimen between Amtrel® and Co-Diovan®. The secondary objectives were listed as
the following.
- To compare the response rate (defined as SBP < 130 mmHg and DBP < 80 mmHg) at the end
of study
- To evaluate the change from baseline in albumin-to-creatinine ratio with
antihypertensive medications in whole group (combined treatment groups) and each
treatment group (Amtrel®, Co-Diovan®) at Week 16
- The change from baseline in glycosylated hemoglobin (HbA1c) at Week 16
- The change from baseline in fasting plasma glucose (FPG) at Week 16
- The change from baseline in fasting lipid profiles (triglyceride, total cholesterol,
high-density lipoprotein cholesterol, low-density lipoprotein cholesterol) at Week 16
- The change from baseline in arteriosclerosis marker (brachial-ankle pulse-wave velocity
(ba-PWV) and ankle-brachial pressure index (ABI), using Colin-VP1000) at Week 16
- The change from baseline on the body mass index (BMI) and waist-hip ratio (WHR) at each
specified study time point
- To ascertain the safety and tolerability of Amtrel® versus Co-Diovan® including AE/SAE,
and laboratory examinations
At the screening visit, patients who fulfilled the entrance criteria and had given written
informed consent entered a placebo running period where they discontinued antihypertensive
medication for two weeks. During that period, Adalat 5mg could be given for emergency. At
the end of placebo running period those patients became hypertensive (i.e., SBP between
130-180mmHg or DBP between 80-110mmHg) were randomized into either treatment group. For
those patients remaining normotensive continued to be on placebo run-in for another two
weeks (10 - 14 days). After the two-week (10 - 14 days) placebo run-in period those patients
became hypertensive were randomized into either treatment group. However for those patients
remaining normotensive were excluded from the study. After randomization into either arm,
patients entered four months treatment period. The dosage adjustment were proceed in order
to reach the best effect. During the treatment period there was a monthly visit to assess
the response of the patients.
The starting dose of Amtrel® was 1 capsule (contains 1/2 tablet) (amlodipine / benazepril
hydrochloride 2.5 mg/ 5 mg) every morning and could be adjusted up to 2 capsules (contains 1
tablet per capsule) (amlodipine / benazepril hydrochloride 10 mg/ 20 mg) every morning if
patients did not achieve the criteria of SBP<130 mmHg and DBP< 80 mmHg during treatment
period.
The starting dose of Co-Diovan® was 1 capsule (contains 1/2 tablet) (valsartan/
hydrochlorothiazide 40 mg/ 6.25 mg) every morning and could be adjusted up to 2 capsules
(contains 1 tablet per capsule) (valsartan/ hydrochlorothiazide 160 mg/ 25.0 mg) every
morning if patients did not achieve the criteria of SBP<130 mmHg and DBP< 80 mmHg during
treatment period.
All randomized patients attended monthly clinic visits for the 16-week treatment period. At
week 4 (Visit 3), all patients were force-titrated to 1 capsule (1 tablet per capsule) for 4
weeks. Subsequently, those patients did not achieve the target blood pressure (SBP<130 mmHg
and DBP<80 mmHg) were titrated monthly to next dose level (2 capsule per day).
;
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Double Blind (Subject, Caregiver, Investigator, Outcomes Assessor), Primary Purpose: Treatment
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