Benidipine-based Comparison of Angiotensin Receptors, β-blockers, or Thiazide Diuretics in Hypertensive Patients

NCT ID: NCT00135551

Last Updated: 2012-02-22

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE4

Total Enrollment

3501 participants

Study Classification

INTERVENTIONAL

Study Start Date

2003-05-31

Study Completion Date

2010-11-30

Brief Summary

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A number of major clinical trials have demonstrated the clinical benefits of lowering blood pressure and have indicated that a majority of patients with hypertension will require more than one drug to achieve optimal blood pressure control.

There is little data showing which antihypertensive combination best protects patients from cardiovascular events and which best achieves the target blood pressure with the fewest adverse events.

The COPE trial is planned to investigate, in patients with hypertension, which combination of the antihypertensive drugs, angiotensin receptor blockers, β-blockers or thiazide diuretics in addition to a long-acting calcium antagonist, benidipine hydrochloride, is superior to achieve the targeted blood pressure and prevent cardiovascular events with the fewest adverse drug effects.

Detailed Description

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Conditions

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Cardiovascular Disease

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

PREVENTION

Blinding Strategy

NONE

Study Groups

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angiotensin receptor blockers

benidipine+angiotensin receptor blockers, titlation scheme

Group Type ACTIVE_COMPARATOR

Angiotensin receptor blockers

Intervention Type DRUG

benidipine+angiotensin receptor blocker, titlation scheme

β-blockers

benidipie+β-blockers, titlation scheme

Group Type ACTIVE_COMPARATOR

β-blockers

Intervention Type DRUG

benidipine+β-blockers, titlation scheme

thiazide diuretics

benidipine+thiazide diuretics, titlation scheme

Group Type ACTIVE_COMPARATOR

thiazide diuretics

Intervention Type DRUG

benidipie+thiazide diuretics, titlation scheme

Interventions

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Angiotensin receptor blockers

benidipine+angiotensin receptor blocker, titlation scheme

Intervention Type DRUG

β-blockers

benidipine+β-blockers, titlation scheme

Intervention Type DRUG

thiazide diuretics

benidipie+thiazide diuretics, titlation scheme

Intervention Type DRUG

Other Intervention Names

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benidipine, angiotensin receptor blockers benidipine, β-blockers benidipie, thiazide diuretics

Eligibility Criteria

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Inclusion Criteria

* Outpatients who are required a combination therapy with sitting systolic blood pressure ≥ 140 mmHg or diastolic blood pressure ≥ 90 mmHg.
* Outpatients aged over 40 years and less than 85 years (inclusive), regardless of sex.
* Previously untreated patients or patients who are on other therapy, which can be converted to 4mg of benidipine.
* Patients who can be treated with benidipine, angiotensin receptor blockers, β-blockers, and thiazide diuretics.

Exclusion Criteria

* Seated systolic blood pressure ≥ 200 mmHg or seated diastolic blood pressure ≥ 120 mmHg.
* Secondary hypertension.
* Type I diabetes mellitus or type 2 diabetes on insulin treatment.
* History of cerebrovascular disorder, myocardial infarction, angina pectoris, coronary angioplasty or coronary artery bypass graft surgery within 6 months prior to enrolment in the study.
* Heart failure (New York Heart Association \[NYHA\] functional classification II, III or IV).
* Chronic atrial fibrillation or atrial flutter.
* Congenital heart disease or a history of rheumatic heart disease.
* Severe peripheral arterial disease (Fontaine Class II, III or IV).
* Serious liver dysfunction (AST or ALT ≥100 IU / l).
* Serious renal dysfunction (serum creatinine ≥ 2mg/dl).
* History of malignancy 5 years prior to study entry.
* Pregnancy.
* Compliance rate \< 70% assessed by a patient interview.
* Known hypersensitivity or contraindication to benidipine, angiotensin receptor blockers, β-blockers, and thiazide diuretics.
* Other serious illness or significant abnormalities that the investigator judges inappropriate for the study
Minimum Eligible Age

40 Years

Maximum Eligible Age

85 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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The Japanese Society of Hypertension

OTHER

Sponsor Role collaborator

Yamaguchi University Hospital

OTHER

Sponsor Role collaborator

Kyowa Hakko Kogyo Co., Ltd.

INDUSTRY

Sponsor Role collaborator

Seiji Umemoto, M.D., Ph.D.

OTHER

Sponsor Role lead

Responsible Party

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Seiji Umemoto, M.D., Ph.D.

Associate Professor

Responsibility Role SPONSOR_INVESTIGATOR

Principal Investigators

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Toshio Ogihara, MD, PhD

Role: PRINCIPAL_INVESTIGATOR

Department of Geriatric Medicine, Osaka University Graduate School of Medicine

Takao Saruta, MD, PhD

Role: STUDY_CHAIR

Department of Internal Medicine, Keio University School of Medicine

Locations

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Department of Medicine and Clinical Science, Yamaguchi University Graduate School of Medicine

Ube, Yamaguchi, Japan

Site Status

Countries

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Japan

References

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Ogihara T, Matsuzaki M, Matsuoka H, Shimamoto K, Shimada K, Rakugi H, Umemoto S, Kamiya A, Suzuki N, Kumagai H, Ohashi Y, Takishita S, Abe K, Saruta T; COPE Trial Group. The combination therapy of hypertension to prevent cardiovascular events (COPE) trial: rationale and design. Hypertens Res. 2005 Apr;28(4):331-8. doi: 10.1291/hypres.28.331.

Reference Type BACKGROUND
PMID: 16138563 (View on PubMed)

Matsuzaki M, Ogihara T, Umemoto S, Rakugi H, Matsuoka H, Shimada K, Abe K, Suzuki N, Eto T, Higaki J, Ito S, Kamiya A, Kikuchi K, Suzuki H, Tei C, Ohashi Y, Saruta T; Combination Therapy of Hypertension to Prevent Cardiovascular Events Trial Group. Prevention of cardiovascular events with calcium channel blocker-based combination therapies in patients with hypertension: a randomized controlled trial. J Hypertens. 2011 Aug;29(8):1649-59. doi: 10.1097/HJH.0b013e328348345d.

Reference Type RESULT
PMID: 21610513 (View on PubMed)

Ogihara T, Matsuzaki M, Umemoto S, Rakugi H, Matsuoka H, Shimada K, Higaki J, Ito S, Kamiya A, Suzuki H, Ohashi Y, Shimamoto K, Saruta T; Combination Therapy of Hypertension to Prevent Cardiovascular Events Trial Group. Combination therapy for hypertension in the elderly: a sub-analysis of the Combination Therapy of Hypertension to Prevent Cardiovascular Events (COPE) Trial. Hypertens Res. 2012 Apr;35(4):441-8. doi: 10.1038/hr.2011.216. Epub 2012 Jan 26.

Reference Type RESULT
PMID: 22278623 (View on PubMed)

Umemoto S, Ogihara T, Matsuzaki M, Rakugi H, Shimada K, Hayashi K, Makino H, Ohashi Y, Saruta T. Effects of an Antihypertensive Combination in Japanese Hypertensive Outpatients Based on the Long-acting Calcium Channel Blocker Benidipine on Vascular and Renal Events: A Sub-analysis of the COPE Trial. Curr Hypertens Rev. 2020;16(3):238-245. doi: 10.2174/1573402116666200129130151.

Reference Type DERIVED
PMID: 31995012 (View on PubMed)

Umemoto S, Ogihara T, Matsuzaki M, Rakugi H, Ohashi Y, Saruta T; Combination Therapy of Hypertension to Prevent Cardiovascular Events COPE Trial Group. Effects of calcium channel blocker-based combinations on intra-individual blood pressure variability: post hoc analysis of the COPE trial. Hypertens Res. 2016 Jan;39(1):46-53. doi: 10.1038/hr.2015.104. Epub 2015 Oct 22.

Reference Type DERIVED
PMID: 26490089 (View on PubMed)

Umemoto S, Ogihara T, Rakugi H, Matsumoto M, Kitagawa K, Shimada K, Higaki J, Ito S, Suzuki H, Ohashi Y, Saruta T, Matsuzaki M; Combination Therapy of Hypertension to Prevent Cardiovascular. Effects of a benidipine-based combination therapy on the risk of stroke according to stroke subtype: the COPE trial. Hypertens Res. 2013 Dec;36(12):1088-95. doi: 10.1038/hr.2013.100. Epub 2013 Aug 29.

Reference Type DERIVED
PMID: 23985703 (View on PubMed)

Related Links

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http://www.jpnsh.org/index_e.html

Japanese Society of Hypertension

http://www.med.osaka-u.ac.jp/pub/geriat/www/

Department of Geriatric Medicine, Osaka University Graduate School of Medicine

Other Identifiers

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copeadministrator

Identifier Type: -

Identifier Source: org_study_id

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