Trial Outcomes & Findings for Effect of High and Low Sodium Diets on Blood Pressure in Hypertensive Patients Treated With Aliskiren (NCT NCT00441064)

NCT ID: NCT00441064

Last Updated: 2011-03-25

Results Overview

The primary objective of the study was to assess mean 24 hour ambulatory systolic blood pressure (MASBP) in systolic hypertensive patients treated with aliskiren (300 mg) for 4 weeks on a high sodium diet versus 4 weeks on a low sodium diet. \[At week 4 patients crossed over from low to high sodium diet and vice versa for 4 weeks. MASBP for patients on high sodium diet versus low sodium diet was also analyzed at week 8 (4 weeks after crossover).\]

Recruitment status

COMPLETED

Study phase

PHASE4

Target enrollment

132 participants

Primary outcome timeframe

Week 4 and week 8 (4 weeks after crossover)

Results posted on

2011-03-25

Participant Flow

A total of 132 patients were randomly assigned to one of the two diet sequences: 69 in the low/high and 63 in the high/low diet sequence. After 4 wks on the assigned diet, patients were then crossed over to the other diet. Patients who were on a high sodium diet for the first 4 wks started on a low sodium diet for the next 4 wks vice versa.

Safety Population (SP) -Included all randomized patients who received at least 1 dose of study medication. Intent-to-treat population (ITT) -All randomized patients who received at least 1 dose of study medication and had at least 1 valid post baseline assessment of primary efficacy variable.

Participant milestones

Participant milestones
Measure
Diet Sequence Low/High Sodium
Patients on low sodium diet ( \<= 100 mmol/day) for the first 4 weeks who crossed over to the high sodium (\>= 200 mmol/day) diet for the next 4 weeks. \[with Aliskiren 300 mg\]
Diet Sequence High/Low Sodium
Patients on high sodium (\>= 200 mmol/day) diet for the first 4 weeks and crossed over to the low sodium diet ( \<= 100 mmol/day) for the next 4 weeks. \[with Aliskiren 300 mg\]
Overall Study
STARTED
69
63
Overall Study
Safety Population (SP)
69
63
Overall Study
Intent-to-treat (ITT) Population
61
57
Overall Study
COMPLETED
59
56
Overall Study
NOT COMPLETED
10
7

Reasons for withdrawal

Reasons for withdrawal
Measure
Diet Sequence Low/High Sodium
Patients on low sodium diet ( \<= 100 mmol/day) for the first 4 weeks who crossed over to the high sodium (\>= 200 mmol/day) diet for the next 4 weeks. \[with Aliskiren 300 mg\]
Diet Sequence High/Low Sodium
Patients on high sodium (\>= 200 mmol/day) diet for the first 4 weeks and crossed over to the low sodium diet ( \<= 100 mmol/day) for the next 4 weeks. \[with Aliskiren 300 mg\]
Overall Study
Adverse Event
1
0
Overall Study
Abnormal laboratory values
0
2
Overall Study
Abnormal test procedure results
0
1
Overall Study
Unsatisfactory therapeutic effect
1
0
Overall Study
Protocol Deviation
3
2
Overall Study
Patient withdrew consent
5
2

Baseline Characteristics

Effect of High and Low Sodium Diets on Blood Pressure in Hypertensive Patients Treated With Aliskiren

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Diet Sequence Low/High Sodium
n=69 Participants
Patients on low sodium diet ( \<= 100 mmol/day) for the first 4 weeks and high sodium (\>= 200 mmol/day) diet for the next 4 weeks. \[with Aliskiren 300 mg\]
Diet Sequence High/Low Sodium
n=63 Participants
Patients on high sodium (\>= 200 mmol/day) diet for the first 4 weeks and on low sodium diet ( \<= 100 mmol/day) for the next 4 weeks. \[with Aliskiren 300 mg\]
Total
n=132 Participants
Total of all reporting groups
Age Continuous
51.0 years
STANDARD_DEVIATION 7.16 • n=5 Participants
52.1 years
STANDARD_DEVIATION 7.75 • n=7 Participants
51.5 years
STANDARD_DEVIATION 7.44 • n=5 Participants
Sex: Female, Male
Female
34 Participants
n=5 Participants
25 Participants
n=7 Participants
59 Participants
n=5 Participants
Sex: Female, Male
Male
35 Participants
n=5 Participants
38 Participants
n=7 Participants
73 Participants
n=5 Participants
MSSBP
147.6 mm Hg
STANDARD_DEVIATION 9.21 • n=5 Participants
146.2 mm Hg
STANDARD_DEVIATION 8.94 • n=7 Participants
146.9 mm Hg
STANDARD_DEVIATION 9.07 • n=5 Participants
MSDBP
92.7 mm Hg
STANDARD_DEVIATION 9.81 • n=5 Participants
93.6 mm Hg
STANDARD_DEVIATION 8.33 • n=7 Participants
93.1 mm Hg
STANDARD_DEVIATION 9.11 • n=5 Participants
MASBP
138.7 mm Hg
STANDARD_DEVIATION 8.30 • n=5 Participants
139.1 mm Hg
STANDARD_DEVIATION 8.52 • n=7 Participants
138.9 mm Hg
STANDARD_DEVIATION 8.38 • n=5 Participants
MADBP
86.6 mm Hg
STANDARD_DEVIATION 6.73 • n=5 Participants
87.7 mm Hg
STANDARD_DEVIATION 7.28 • n=7 Participants
87.1 mm Hg
STANDARD_DEVIATION 6.99 • n=5 Participants

PRIMARY outcome

Timeframe: Week 4 and week 8 (4 weeks after crossover)

Population: Completers Population: Included all patients who completed both diet periods - high and low sodium diets

The primary objective of the study was to assess mean 24 hour ambulatory systolic blood pressure (MASBP) in systolic hypertensive patients treated with aliskiren (300 mg) for 4 weeks on a high sodium diet versus 4 weeks on a low sodium diet. \[At week 4 patients crossed over from low to high sodium diet and vice versa for 4 weeks. MASBP for patients on high sodium diet versus low sodium diet was also analyzed at week 8 (4 weeks after crossover).\]

Outcome measures

Outcome measures
Measure
Low Sodium Diet
n=115 Participants
All patients who were on low sodium (\<= 100 mmol/day) diet
High Sodium Diet
n=115 Participants
All patients who were on high sodium (\>= 200 mmol/day) diet
Mean 24 Hour Ambulatory Systolic Blood Pressure (MASBP) in Systolic Hypertensive Patients Treated With Aliskiren (300 mg) for 4 Weeks on a High Sodium Diet Versus 4 Weeks on a Low Sodium Diet
Period 1 (4 weeks)
124.8 mm Hg
Standard Deviation 9.12
134.7 mm Hg
Standard Deviation 11.13
Mean 24 Hour Ambulatory Systolic Blood Pressure (MASBP) in Systolic Hypertensive Patients Treated With Aliskiren (300 mg) for 4 Weeks on a High Sodium Diet Versus 4 Weeks on a Low Sodium Diet
Period 2 (next 4 weeks after crossover)
123.6 mm Hg
Standard Deviation 11.69
132.5 mm Hg
Standard Deviation 10.07

SECONDARY outcome

Timeframe: Week 4 and week 8 (4 weeks after crossover)

Population: Completers Population: Included all patients who completed both diet periods - high and low sodium diets

To evaluate the mean 24 hour ambulatory diastolic blood pressure (MADBP) in systolic hypertensive patients treated with aliskiren (300 mg) for 4 weeks on a high sodium diet versus 4 weeks on a low sodium diet. \[At week 4 patients crossed over from low to high sodium diet and vice versa for 4 weeks. MADBP for patients on high sodium diet versus low sodium diet was also analyzed at week 8 (4 weeks after crossover).\]

Outcome measures

Outcome measures
Measure
Low Sodium Diet
n=115 Participants
All patients who were on low sodium (\<= 100 mmol/day) diet
High Sodium Diet
n=115 Participants
All patients who were on high sodium (\>= 200 mmol/day) diet
Mean 24 Hour Ambulatory Diastolic Blood Pressure (MADBP) in Systolic Hypertensive Patients Treated With Aliskiren (300 mg) for 4 Weeks on a High Sodium Diet Versus 4 Weeks on a Low Sodium Diet
Period 1 (4 weeks)
78.5 mm Hg
Standard Deviation 7.37
85.0 mm Hg
Standard Deviation 9.06
Mean 24 Hour Ambulatory Diastolic Blood Pressure (MADBP) in Systolic Hypertensive Patients Treated With Aliskiren (300 mg) for 4 Weeks on a High Sodium Diet Versus 4 Weeks on a Low Sodium Diet
Period 2 (next 4 weeks after crossover)
78.3 mm Hg
Standard Deviation 9.10
83.2 mm Hg
Standard Deviation 8.10

SECONDARY outcome

Timeframe: Week 4 and Week 8 (4 weeks after crossover)

Population: Completers Population: Included all patients who completed both diet periods - high and low sodium diets

To evaluate the percentage of responders defined as MASBP \< 130 mm Hg or a decrease in MASBP from baseline of ≥20 mm Hg in systolic hypertensive patients treated with aliskiren (300 mg) for 4 weeks on a high sodium diet versus 4 weeks on a low sodium diet. \[At week 4 patients crossed over from low to high sodium diet and vice versa for 4 weeks. Percent response for patients on high sodium diet versus low sodium diet was also analyzed at week 8 (4 weeks after crossover).\]

Outcome measures

Outcome measures
Measure
Low Sodium Diet
n=115 Participants
All patients who were on low sodium (\<= 100 mmol/day) diet
High Sodium Diet
n=115 Participants
All patients who were on high sodium (\>= 200 mmol/day) diet
Percentage of Responders Defined as MASBP <130 mm Hg or a Decrease From Baseline in MASBP of ≥20 mm Hg in Systolic Hypertensive Patients Treated With Aliskiren (300 mg) for 4 Weeks on a High Sodium Diet Versus 4 Weeks on a Low Sodium Diet
Period 1 (4 weeks) - Response
78.0 Percentage of responders
41.1 Percentage of responders
Percentage of Responders Defined as MASBP <130 mm Hg or a Decrease From Baseline in MASBP of ≥20 mm Hg in Systolic Hypertensive Patients Treated With Aliskiren (300 mg) for 4 Weeks on a High Sodium Diet Versus 4 Weeks on a Low Sodium Diet
Period 1 (4 weeks) - No response
20.3 Percentage of responders
58.9 Percentage of responders
Percentage of Responders Defined as MASBP <130 mm Hg or a Decrease From Baseline in MASBP of ≥20 mm Hg in Systolic Hypertensive Patients Treated With Aliskiren (300 mg) for 4 Weeks on a High Sodium Diet Versus 4 Weeks on a Low Sodium Diet
Period 2 (next 4 weeks after crossover) - Response
75.0 Percentage of responders
44.1 Percentage of responders
Percentage of Responders Defined as MASBP <130 mm Hg or a Decrease From Baseline in MASBP of ≥20 mm Hg in Systolic Hypertensive Patients Treated With Aliskiren (300 mg) for 4 Weeks on a High Sodium Diet Versus 4 Weeks on a Low Sodium Diet
Period 2 (next 4 wks after crossover) -No Response
25.0 Percentage of responders
55.9 Percentage of responders

Adverse Events

Low Sodium Diet

Serious events: 0 serious events
Other events: 3 other events
Deaths: 0 deaths

High Sodium Diet

Serious events: 0 serious events
Other events: 8 other events
Deaths: 0 deaths

Serious adverse events

Adverse event data not reported

Other adverse events

Other adverse events
Measure
Low Sodium Diet
n=126 participants at risk
All patients who were on low sodium (\<= 100 mmol/day) diet.
High Sodium Diet
n=124 participants at risk
All patients who were on high sodium (\>= 200 mmol/day) diet.
Nervous system disorders
Headache
2.4%
3/126 • AE's in overall Safety Population (SP) after 8 weeks
Numbers in AE table are by overall diet, not diet sequence. AEs included overall Safety Population. Low Sodium Diet: 126=69 starters+57 after crossover (56 Completed + 1 who received medication but did not complete study); High Sodium Diet: 124=63 starters+61 after crossover (59 Completed + 2 who received medication but did not complete study)
6.5%
8/124 • AE's in overall Safety Population (SP) after 8 weeks
Numbers in AE table are by overall diet, not diet sequence. AEs included overall Safety Population. Low Sodium Diet: 126=69 starters+57 after crossover (56 Completed + 1 who received medication but did not complete study); High Sodium Diet: 124=63 starters+61 after crossover (59 Completed + 2 who received medication but did not complete study)

Additional Information

Study Director

Novartis Pharmaceuticals

Phone: 862-778-8300

Results disclosure agreements

  • Principal investigator is a sponsor employee The terms and conditions of Novartis' agreements with its investigators may vary. However, Novartis does not prohibit any investigator from publishing. Any publications from a single-site are postponed until the publication of the pooled data (i.e., data from all sites) in the clinical trial; or the publication of the trial results in their entirety.
  • Publication restrictions are in place

Restriction type: OTHER