Hypertension Clinical Trial
Official title:
A Randomized, Open-label, Positive Drug Controlled Clinical Trials to Compare the Efficacy of Nitrendipine and Hydrochlorothiazide , Captopril Plus Hydrochlorothiazide and Beijing Hypotensive No.0 in Tibetan Hypertension
Several surveys had revealed that Tibetan adults had high prevalence of hypertension. However, there was no research studying the antihypertensive effect of the known drugs in Tibetan. The main arms of our study were to determine if the efficacy of lowing blood pressure and protecting target organ damage differs between nitrendipine and Hydrochlorothiazide in mild hypertension in Tibetan, and to determine if the efficacy of lowing blood pressure and protecting target organ damage differs between captopril plus Hydrochlorothiazide and Beijing hypotensive No.0 in moderate and severe Tibetan hypertension.
Several surveys had revealed that Tibetan adults had high blood pressure(BP)and prevalence
of hypertension than other parts of China and were also higher than those in developed
nations as well. For example, one study found that among Tibetan herdsmen 40 years and
older, the prevalence of hypertension was 56% and the mean systolic blood pressure/diastolic
blood pressure was 146.6/92.0mmHg. However, the rates of awareness, treatment, and control
were dismally low.
The Tibetan have been living in the Tibetan Plateau. The special natural and social
environment there,as well as ethnic ,may all be involved in the etiology of the high
prevalence and effect the response to antihypertensive treatment. Nevertheless, few
interventional studies have been done in Tibetan hypertensive patients. Therefore, the
purpose of our study was to compare the blood pressure reduction between different
antihypertensive drugs. Nitrendipine, hydrochlorothiazide, captopril and Beijing hypotensive
No.0 (also named" compound hypotensive tablet") are selected, which are cheap and available
in the Tibetan Plateau.
Nitrendipine, hydrochlorothiazide and captopril are the representatives of Dihydropyridines
Calcium antagonists, diuretics, and angiotensin-converting enzyme inhibitors, respectively.
They are all recommended as the first-line antihypertensive drug. Beijing hypotensive No.0
is produce by China Resources Double-crane Pharmaceutical company in China, and it is a
fixed-dose combination containing reserpine 0.1mg, hydrochlorothiazide 12.5mg, dihydralazine
sulfate 12.5mg, triamterene 12.5mg. Many studies conducted in China have demonstrated its
efficacy and safety in lowing blood pressure.
After recruitment, participant will be grouped according to their BP. If BP<160/100mmHg,
monotherapy is started. Patient is randomly assigned to receive nitrendipine 10mg bid or
Hydrochlorothiazide 12.5mg qd. If BP≥160/100mmHg, Patient is randomly assigned to receive
two drug combination therapy(captopril 25mg three times daily (tid) and Hydrochlorothiazide
12.5mg qd) or Beijing hypotensive No.0 one pile qd. During the following 12 months,each
participant will take at least four visits at 1、3、6 and 12 months respectively. Goal BP for
all participants was less than 140/90mmHg, achieved by titrating the assigned study drug and
adding open-label agents when necessary. The maximum dosage is 20mg BID for nitrendipine,
25mg qd for Hydrochlorothiazide and 50mg tid for captopril. The dosage of Beijing
hypotensive No.0 should not be added.
;
Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Treatment
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