Combination of OLMesartan and CCB or Low Dose Diuretics in High Risk Elderly Hypertensive Patients Study (COLM-Study)

NCT ID: NCT00454662

Last Updated: 2013-01-23

Basic Information

• Recruitment Status: COMPLETED
• Clinical Phase: PHASE4
• Total Enrollment: 5141 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2007-04-30
• Study Completion Date: 2011-09-30

Brief Summary

The purpose of this study is to investigate which combination therapy is more effective in reducing the incidence of cardiovascular events in Japanese elderly high-risk hypertensive patients: AT1 subtype angiotensin II receptor antagonist/calcium channel blocker or AT1 subtype angiotensin II receptor antagonist/low dose diuretic.

Detailed Description

Recently, antihypertensive combination therapies have been recommended by various guidelines because of their additive effects. Combination therapies of AT1 subtype angiotensin II receptor antagonist and calcium channel blocker or low dose diuretic have shown pharmacological benefit. However, reduction of cardiovascular events and safety profile of these combination therapies under same level of antihypertensive target have not been investigated yet.

In this study, primary objective is to compare two combination therapies when antihypertensive target is 140/90mmHg in elderly hypertensive patients with high cardiovascular risk.

Further study details as provided by COLM-Study data center

Primary Outcomes: A composite of fatal and non-fatal cardiovascular events: Sudden death (death of endogenous origin within 24 hours after acute onset); Cerebrovascular events (new occurrence or recurrence of a cerebral infarction, cerebral hemorrhage, subarachnoid hemorrhage or transient ischemic attack); Coronary events (new occurrence or recurrence of a myocardial infarction, coronary revascularization[PCI or CABG], hospitalization for angina pectoris, hospitalization for heart failure); Renal dysfunction (doubling of serum creatinine and creatinine ≥2.0 mg/dl, end stage renal disease) Secondary Outcomes: All deaths; Death from cardiovascular events; Effects on glucose metabolism(fasting plasma glucose, postprandial glucose, new onset of diabetes mellitus); Incidence of primary outcomes events; New occurrence of atrial fibrillation; Safety; Proportion of the subjects who withdrew from the allocated treatment

Conditions

Hypertension; Cardiovascular Disease; Diabetes

Study Design

• Allocation Method: RANDOMIZED
• Intervention Model: PARALLEL
• Primary Study Purpose: PREVENTION
• Blinding Strategy: SINGLE

Study Groups

1

olmesartan medoxomil, Calcium channel blockers (amlodipine, azelnidipine)

Group Type: ACTIVE_COMPARATOR

olmesartan medoxomil / amlodipine or azelnidipine

Intervention Type: DRUG

AT1 subtype angiotensin II receptor antagonist / calcium channel blocker : 5-40mg of olmesartan medoxomil / 2.5-5mg of amlodipine or 8-16mg of azelnidipine

2

AT1 subtype angiotensin II receptor antagonist/low dose diuretic

Group Type: ACTIVE_COMPARATOR

olmesartan medoxomil / low dose thiazide type drug

Intervention Type: DRUG

AT1 subtype angiotensin II receptor antagonist / low dose diuretic : 5-40mg of olmesartan medoxomil / low dose thiazide type drug

Interventions

olmesartan medoxomil / amlodipine or azelnidipine

AT1 subtype angiotensin II receptor antagonist / calcium channel blocker : 5-40mg of olmesartan medoxomil / 2.5-5mg of amlodipine or 8-16mg of azelnidipine

Intervention Type: DRUG

olmesartan medoxomil / low dose thiazide type drug

AT1 subtype angiotensin II receptor antagonist / low dose diuretic : 5-40mg of olmesartan medoxomil / low dose thiazide type drug

Intervention Type: DRUG

Eligibility Criteria

Inclusion Criteria

• Outpatients aged 65 years or older, and less than 85 years (at the time of informed consent), regardless of sex
• Systolic blood pressure (SBP) ≥140 mmHg or diastolic blood pressure (DBP) ≥90 mmHg in a sitting position on two consecutive measurements at clinic during use of 1 or more antihypertensive medications.
• Systolic blood pressure (SBP) ≥160 mmHg or diastolic blood pressure (DBP) ≥100 mmHg in a sitting position on two consecutive measurements at clinic without antihypertensive medication.
• Require at least one of the following medical history or risk factors
• Medical history

• Cerebrovascular accident: cerebral infarction, brain hemorrhage, subarachnoid hemorrhage（6 months or more prior to registration）
• Myocardial infarction, coronary revascularization (PCI or CABG) （6 months or more prior to registration）
• Angina pectoris (except for the patients having history of hospitalization within 6 months prior to registration)
• Risk factors

• Male
• Current diabetes mellitus, fasting glucose ≥ 110mg/dL or postprandial glucose ≥ 140mg/dl
• Hypercholesterolemia (Total cholesterol ≥ 260mg/dL)
• Low HDL cholesterolemia (HDL-C <40mg/dL)
• Microalbuminuria (albumin/cr ≥ 30mg/gCr) or proteinuria (protein ≥ 1＋)
• Left ventricular hypertrophy (ST-T change in the ECG and SV1＋RV5 ≥ 35mm, or left ventricular mass index: male ≥ 125 g/m2, female ≥ 110 g/m2)

Exclusion Criteria

• Secondary hypertension or malignant hypertension
• History of cerebrovascular accident (including TIA) or myocardial infarction within 6 months before registration
• Percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG) done within 6 months before registration or scheduled
• History of hospitalization for angina pectoris or heart failure within 6 months before registration
• Severe heart failure (New York Heart Association [NYHA] functional class III or more severe)
• Complications of atrial fibrillation, atrial flutter or severe arrhythmia
• Severe hepatic or renal dysfunction (including current treatment of dialysis or renal dysfunction with serum creatinine ≥ 2.0mg/dL)
• Not appropriate for change to the study drugs from current therapy for concurrent disease including coronary diseases (i.e. calcium channel blockers, diuretics, etc)
• History of serious side effect from study drugs (AT1 subtype angiotensin II receptor antagonist, calcium channel blocker, diuretic)
• Life threatening condition (malignant tumor, etc)
• Not suited to be study subject judged by a study physician

• Minimum Eligible Age: 65 Years
• Maximum Eligible Age: 84 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

Japan Heart Foundation

OTHER

Sponsor Role: collaborator

COLM Study Research Organization

OTHER

Sponsor Role: lead

Responsible Party

Responsibility Role: SPONSOR

Principal Investigators

Toshio Ogihara, MD

Role: STUDY_CHAIR

Emeritus Professor Osaka University

Takao Saruta, MD

Role: STUDY_CHAIR

Emeritus Professor Keio University

Locations

COLM-Study Data Center

Kamiyacho Mount Bld.14F, 4-3-20 Toranomon Minato-ku, Tokyo, Japan

Countries

Japan

References

Rakugi H, Ogihara T, Saruta T, Kawai T, Saito I, Teramukai S, Shimada K, Katayama S, Higaki J, Odawara M, Tanahashi N, Kimura G; COLM Investigators. Preferable effects of olmesartan/calcium channel blocker to olmesartan/diuretic on blood pressure variability in very elderly hypertension: COLM study subanalysis. J Hypertens. 2015 Oct;33(10):2165-72. doi: 10.1097/HJH.0000000000000668.

Reference Type: DERIVED

PMID: 26066644 (View on PubMed)

Other Identifiers

COLM001

Identifier Type: -

Identifier Source: secondary_id

31-JAN-2007

Identifier Type: -

Identifier Source: org_study_id