Hypertension Clinical Trial
Official title:
The Hypotensive Effect of Simvastatin in Hypertensive Patients: a Placebo-controlled Randomized Clinical Trial With 24-h Ambulatory Blood Pressure Monitoring
The proposed study is to evaluate the possible effect of metformin on arterial pressure by 24h-ambulatory blood pressure monitory (24h-ABPM).
The primary outcome was the difference in mean 24-hour blood pressure variation between the
two groups after the intervention. The difference in mean of blood pressure during daytime
and nighttime in 24h ambulatory blood pressure monitory, as well as the office BP and
laboratory differences were considered secondary outcomes.
This randomized, double-blind parallel study was conducted in the Hypertension Clinic of the
Department of Cardiology, Hospital de Clínicas de Porto Alegre (Porto Alegre, Brazil).
We selected hypertensive individuals (controlled or not) without diabetes aged 18-70 years.
Exclusion criteria: metformin intolerance, creatinine > 1,5 mg/dl Risks: adverse effects
related to metformin use, mainly diarrhea and nausea Benefits: possible lower effect on
arterial pressure Statistical analysis: sample size was calculated on the basis of a
standard deviation of 8 mm Hg and effect size of 5 mm Hg in 24-h systolic ABPM and a
two-sided significance level of 5%. A sample size of 42 patients per group was estimated to
provide a power of 80% to reject the null hypothesis. Considering possible 10% of losses,
the final calculated sample was 92 patients.
The baseline comparison between groups was performed using the Student t test for continuous
variables and x2 for categorical variables. In each group, the change in BP by ABPM -24 h,
daytime and nighttime, and laboratory tests was calculated by subtracting baseline values
measured after the intervention period. The difference between groups was calculated by
subtracting the variation observed between them (δ-values). The differences in BP variation
and laboratory tests were analyzed by analysis of variance for repeated measures (MANOVA).
For differences in pressure variation adjustment was considered for the baseline BP values
(analysis of covariance). All tests were two-tailed and significance level was 5%. Data were
analyzed using Statistical Package for the Social Sciences (SPSS) version 13.0.
;
Allocation: Randomized, Endpoint Classification: Safety Study, Intervention Model: Single Group Assignment, Masking: Double Blind (Subject, Investigator), Primary Purpose: Treatment
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