- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT01409408
Comparison of Amlodipine and Aliskiren in Diabetic Hypertensive Patient With Blood Pressure Not Controlled by Losartan
March 5, 2012 updated by: Hospital Universitario Pedro Ernesto
Comparison Between Amlodipine and Aliskiren in Diabetic Hypertensive Patient With Blood Pressure Not Controlled by Losartan: Effects on Endothelial Function and Renin Concentration and Activity
Assess if aliskiren is capable of enhancing vascular stiffness and endothelial function and compare theses effects and renin activity and concentration to those obtained with a calcium channel blocker, amlodipine, in patients with diabetes mellitus type 2 and blood pressure not controlled by 100 mg per day of losartan.
Study Overview
Status
Withdrawn
Conditions
Intervention / Treatment
Detailed Description
Hypertension and diabetes mellitus are important risk factors for cardiovascular morbidity and mortality.
Endothelial dysfunction and vascular rigidity are two pathophysiological mechanisms that may explain this relationship.
Recent publications showed that both ACEi (angiotensin converting enzyme inhibitor) and ARB (angiotensin receptor blocker) were capable of improving vascular stiffness and endothelial function, and that these effects occurred despite blood pressure reduction.
The major debate that persists is which drug to associate with ACEi or ARB to achieve blood pressure control in diabetic patients.
Recent studies showed that even in patients under ACEi or ARB therapy there may be residual activity in the renin-angiotensin-aldosterone system (RASS).
Direct renin inhibitors (DRI) are a new class of anti-hypertensive drugs that may complement the blockade of the RASS.
Aliskiren was the first drug of this class that completed phase 3 studies and marketed in the 21th century.
It's main advantage is that DRI may reduce angiotensin II and aldosterone synthesis without increasing renin levels.
This study main objective is to assess if aliskiren is capable of enhancing vascular stiffness and endothelial function and compare theses effects to those obtained with a calcium channel blocker, amlodipine, in patients with diabetes mellitus type 2 and blood pressure not controlled by 100 mg per day of losartan.
Vascular stiffness and endothelial function will be measured by: pulse wave velocity, augmentation index, brachial artery flow-mediated vasodilation, peripheral arterial tonometry (EndoPat).
Another main objective is to compare plasma renin activity and concentration between those groups.
Study Type
Interventional
Phase
- Phase 4
Contacts and Locations
This section provides the contact details for those conducting the study, and information on where this study is being conducted.
Study Locations
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Rio de Janeiro, Brazil, 20551030
- Hospital Universitário Pedro Ernesto
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Participation Criteria
Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.
Eligibility Criteria
Ages Eligible for Study
40 years to 70 years (Adult, Older Adult)
Accepts Healthy Volunteers
No
Genders Eligible for Study
All
Description
Inclusion Criteria:
- Ambulatorial patients with age between 40 and 70 years-old.
- Systemic arterial hypertension previously diagnosed and in use of two or less anti-hypertensive drugs in the preceding 4 weeks.
- Those patients without anti-hypertensive drug prescribed in the last 4 weeks with office systolic blood pressure between 140 and 159 mmHg and diastolic between 90 and 109 mmHg.
- Type 2 diabetes mellitus in use of oral medication that were not changed in the preceding 4 weeks. Glycated hemoglobin A1c less than 9.0%.
- Accepted the consent form.
Exclusion Criteria:
- Office systolic blood pressure equal or more than 180 mmHg, with or without treatment
- Office diastolic blood pressure equal or more than 110 mmHg, with or without treatment
- Evidences of a secondary cause for hypertension
- Glycated hemoglobin A1c > 9.0%
- Insulin therapy
- Chronic kidney disease of level 3 to 5 or in dialysis
- Advanced target organ lesion, obtained by history or additional exams, and defined by: previous myocardial infarction, heart failure with ejection fraction less than 40%, cerebral vascular accident (ischemic or hemorrhagic), peripheral vascular disease (claudication or doppler with obstruction > 50% of vascular lumen), retinopathy with visual loss, symptomatic neuropathy.
- Cardiac arrhythmias, except for ectopic beats
- Any clinical or disabling condition that, in the opinion of the investigators, may confound or prejudice study results.
Study Plan
This section provides details of the study plan, including how the study is designed and what the study is measuring.
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Double
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
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Active Comparator: Aliskiren
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300 mg of aliskiren daily for 8 weeks.
Other Names:
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Active Comparator: Amlodipine
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Amlodipine 5 mg daily for 8 weeks.
Other Names:
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What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Vascular stiffness
Time Frame: 8 weeks
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Vascular stiffness will be measured by pulse wave velocity and augmentation index and compared between anlodipine and aliskiren.
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8 weeks
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Endothelial function
Time Frame: 8 weeks
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Access endothelial function by peripheral arterial tonometry and brachial flow-mediated vasodilation and compare it between anlodipine and aliskiren.
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8 weeks
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Renin activity and concentration
Time Frame: 8 weeks
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Access plasma renin activity and concentration and compare it between anlodipine and aliskiren.
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8 weeks
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Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Compare drug effects in office blood pressure measurements to those obtained by home blood pressure monitoring and ambulatory blood pressure monitoring
Time Frame: 8 weeks
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Compare drug effects in office blood pressure measurements to those obtained by home blood pressure monitoring and ambulatory blood pressure monitoring
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8 weeks
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Assess drugs effects in renin-angiotensin-aldosterone system (RAAS) and correlate it to renin concentration/mass and plasmatic renin activity
Time Frame: 8 weeks
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Assess drugs effects in RAAS and correlate it to renin concentration/mass and plasmatic renin activity
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8 weeks
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Correlation of drug effects and uric acid plasmatic concentration
Time Frame: 8 weeks
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Correlation of drug effects and uric acid plasmatic concentration
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8 weeks
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Correlation of drug effects and glomerular filtration rate
Time Frame: 8 weeks
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Correlation of drug effects and glomerular filtration rate
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8 weeks
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Correlation of drug effects and microalbuminuria
Time Frame: 8 weeks
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Correlation of drug effects and microalbuminuria
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8 weeks
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Correlation of drug effects and left ventricular mass and function (systolic and diastolic)
Time Frame: 8 weeks
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Correlation of drug effects and left ventricular mass and function (systolic and diastolic)
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8 weeks
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Collaborators and Investigators
This is where you will find people and organizations involved with this study.
Collaborators
Investigators
- Principal Investigator: Ronaldo A Gismondi, MD, DsC, HUPedroernesto (UERJ)
- Study Director: Mario F Neves, MD, PhD, HUPedroernesto (UERJ)
- Study Chair: Wille Oigman, MD, PhD, HUPedroernesto (UERJ)
Study record dates
These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.
Study Major Dates
Study Start
April 1, 2011
Primary Completion (Anticipated)
April 1, 2013
Study Completion (Anticipated)
December 1, 2013
Study Registration Dates
First Submitted
August 1, 2011
First Submitted That Met QC Criteria
August 3, 2011
First Posted (Estimate)
August 4, 2011
Study Record Updates
Last Update Posted (Estimate)
March 6, 2012
Last Update Submitted That Met QC Criteria
March 5, 2012
Last Verified
April 1, 2011
More Information
Terms related to this study
Additional Relevant MeSH Terms
- Cardiovascular Diseases
- Vascular Diseases
- Glucose Metabolism Disorders
- Metabolic Diseases
- Endocrine System Diseases
- Hypertension
- Diabetes Mellitus
- Physiological Effects of Drugs
- Molecular Mechanisms of Pharmacological Action
- Antihypertensive Agents
- Vasodilator Agents
- Membrane Transport Modulators
- Calcium-Regulating Hormones and Agents
- Calcium Channel Blockers
- Amlodipine
Other Study ID Numbers
- CAALIDH
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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