Newer Versus Older Antihypertensive Agents in African Hypertensive Patients (NOAAH) Trial

NCT ID: NCT01030458

Last Updated: 2013-12-09

Study Results

Results available

Outcome measurements, participant flow, baseline characteristics, and adverse events have been published for this study.

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Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE4

Total Enrollment

183 participants

Study Classification

INTERVENTIONAL

Study Start Date

2010-09-30

Study Completion Date

2012-03-31

Brief Summary

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The purpose of this study is to compare the blood pressure lowering efficacy of a treatment regimen based on a dihydropyridine calcium-channel blocker combined with an angiotensin II type-1 receptor blocker with the recommended treatment regimen based on a low-dose thiazide diuretic combined with a beta-blocker.

Detailed Description

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Primary objective:

Sitting systolic blood pressure (average of three readings) will be the primary outcome variable.

Secondary

1. To compare the time interval between the two treatment groups, which after randomisation will be required, to reach and maintain the target defined as a blood pressure below 140 mm Hg systolic and 90 mm Hg diastolic;
2. To compare the duration of follow-up, during which a steady blood pressure control will be achieved;
3. To evaluate the incidence of adverse events, symptoms, biochemical abnormalities and ECG changes in the two treatment groups;
4. To assess the adherence to antihypertensive treatment as well as the rate of drop-outs in both treatment arms during a six-month period.

Conditions

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Blood Pressure

Keywords

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Blood pressure Hypertension Blacks Africa Blood pressure control Side-effects

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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amlodipine plus valsartan

In the experimental group, Exforge will be used in two dosage steps, respectively, amlodipine 5 mg plus 160 mg valsartan and amlodipine 10 mg plus 160 mg valsartan.

Group Type EXPERIMENTAL

amlodipine 5/10 mg per day plus valsartan 160 mg/day

Intervention Type DRUG

Amlodipine 5/10 mg/day plus valsartan 160 mg/day, once daily, in the morning

hydrochlorothiazide plus bisoprolol

In the reference group, the Lodoz will be used in two dosage steps, respectively 6.25 mg hydrochlorothiazide plus 5 mg or 6.25 mg hydrochlorothiazide plus 10 mg bisoprolol

Group Type ACTIVE_COMPARATOR

hydrochlorothiazide 6.25 mg/day plus bisoprolol 5/10 mg/day

Intervention Type DRUG

hydrochlorothiazide 6.25 mg/day plus bisoprolol 5/10 mg/day, once daily, in the morning

Interventions

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amlodipine 5/10 mg per day plus valsartan 160 mg/day

Amlodipine 5/10 mg/day plus valsartan 160 mg/day, once daily, in the morning

Intervention Type DRUG

hydrochlorothiazide 6.25 mg/day plus bisoprolol 5/10 mg/day

hydrochlorothiazide 6.25 mg/day plus bisoprolol 5/10 mg/day, once daily, in the morning

Intervention Type DRUG

Other Intervention Names

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ExForge® Lodoz®

Eligibility Criteria

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Inclusion Criteria

* Women or men within an age range from 30 to 69 years with uncomplicated hypertension.
* Blood pressure measured in the sitting position after at least 5 minutes rest (average of three readings at the last run-in-visit) should range from 140 to 179 mm Hg systolic or from 90 to 109 mm Hg diastolic (grades 1 or 2 of hypertension). Patients must have uncomplicated hypertension with a maximum of two additional risk factors, as defined in the 2007 guidelines of the European Societies of Hypertension and Cardiology.
* Systolic blood pressure in the upright position must be at least 110 mm Hg (mean of three readings obtained immediately after the patient has assumed a standing position).
* Patients who have never been treated for hypertension or in whom previous antihypertensive drug treatment has been discontinued for at least four weeks before the last run-in visit can be randomised. If two weeks after discontinuation of previous antihypertensive treatment the blood pressure is higher than 160 mm Hg systolic or higher than 100 mm Hg diastolic and if the patient has complaints, the patient can be randomised immediately to active blood pressure lowering treatment with either the newer or older antihypertensive drugs.
* The patient must provide informed written consent.

Exclusion Criteria

* Premenopausal women not applying anticonception.
* A history of cardiovascular disease.
* Secondary hypertension.
* Electrocardiographic left ventricular hypertrophy.
* More than two cardiovascular risk factors in addition to hypertension.
* Diabetes mellitus.
* Renal dysfunction.
* Recent treatment with two or more antihypertensive drugs or a contra-indication to discontinue blood pressure lowering agents for 4 weeks.
* Severe non-cardiovascular disease.
* Known contra indications for the first-line study medications.
Minimum Eligible Age

30 Years

Maximum Eligible Age

69 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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University of Kinshasa

OTHER

Sponsor Role collaborator

Yaounde Central Hospital

OTHER_GOV

Sponsor Role collaborator

University of Yaounde

OTHER

Sponsor Role collaborator

University of Libreville

UNKNOWN

Sponsor Role collaborator

Institute of Cardiology Abidjan

UNKNOWN

Sponsor Role collaborator

University of Ilorin Teaching Hospital

OTHER

Sponsor Role collaborator

University of Nigeria, Enugu Campus

OTHER

Sponsor Role collaborator

Hospital Aristide Le Dantec, Dakar, Senegal

UNKNOWN

Sponsor Role collaborator

KU Leuven

OTHER

Sponsor Role lead

Responsible Party

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Jan A. Staessen

Professor of Medicine, MD, PhD

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Samuel Kingue, MD

Role: PRINCIPAL_INVESTIGATOR

Hôpital Général de Yaoundé, BP 5408, Yaoundé, Cameroun

Daniel Lemogoum, MD, PhD

Role: PRINCIPAL_INVESTIGATOR

Université de Douala, Douala, Cameroon

Bruno Mipinda, MD

Role: PRINCIPAL_INVESTIGATOR

Hôpital Central Universitaire de Libreville, Libreville, Gabon

Omotoso Babatunde, MD

Role: PRINCIPAL_INVESTIGATOR

University of Ilorin, Ilorin, Nigeria

Ifeoma E Ulasi, MD

Role: PRINCIPAL_INVESTIGATOR

University of Enugu, Enugu, Nigeria

Serigne Abdou Ba, MD

Role: PRINCIPAL_INVESTIGATOR

Hôpital Aristide Le Dantec, Dakar, Sénégal

Jean-René M'Buyamba-Kabangu, MD, PhD

Role: STUDY_CHAIR

University of Kinshasa, Kinshasa, Democratic Republic of Congo

Jan A Staessen, MD, PhD

Role: STUDY_DIRECTOR

University of Leuven, Leuven, Belgium

Locations

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Ecole de Médecine de Douala

Douala, , Cameroon

Site Status

Hôpital Général de Yaoundé

Yaoundé, , Cameroon

Site Status

Institut de Cardiologie d'Abidjan

Abidjan, , Côte d’Ivoire

Site Status

Hôpital Central Universitaire de Libreville

Libreville, , Gabon

Site Status

University of Enugu

Enugu, , Nigeria

Site Status

University of Ilorin

Ilorin, , Nigeria

Site Status

Hôpital Aristide Le Dantec

Dakar, , Senegal

Site Status

Countries

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Cameroon Côte d’Ivoire Gabon Nigeria Senegal

References

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Odili AN, Richart T, Thijs L, Kingue S, Boombhi HJ, Lemogoum D, Kaptue J, Kamdem MK, Mipinda JB, Omotoso BA, Kolo PM, Aderibigbe A, Ulasi II, Anisiuba BC, Ijoma CK, Ba SA, Ndiaye MB, Staessen JA, M'buyamba-Kabangu JR; NOAAH Investigators. Rationale and design of the Newer Versus Older Antihypertensive Agents in African Hypertensive Patients (NOAAH) trial. Blood Press. 2011 Oct;20(5):256-66. doi: 10.3109/08037051.2011.572614. Epub 2011 Apr 15.

Reference Type BACKGROUND
PMID: 21495829 (View on PubMed)

M'Buyamba-Kabangu JR, Anisiuba BC, Ndiaye MB, Lemogoum D, Jacobs L, Ijoma CK, Thijs L, Boombhi HJ, Kaptue J, Kolo PM, Mipinda JB, Osakwe CE, Odili A, Ezeala-Adikaibe B, Kingue S, Omotoso BA, Ba SA, Ulasi II, Staessen JA; Newer versus Older Antihypertensive Agents in African Hypertensive Patients Trial (NOAAH) Investigators. Efficacy of newer versus older antihypertensive drugs in black patients living in sub-Saharan Africa. J Hum Hypertens. 2013 Dec;27(12):729-35. doi: 10.1038/jhh.2013.56. Epub 2013 Jun 27.

Reference Type RESULT
PMID: 23803591 (View on PubMed)

Osakwe CE, Jacobs L, Anisiuba BC, Ndiaye MB, Lemogoum D, Ijoma CK, Kamdem MM, Thijs L, Boombhi HJ, Kaptue J, Kolo PM, Mipinda JB, Odili AN, Ezeala-Adikaibe B, Kingue S, Omotoso BA, Ba SA, Ulasi II, M'buyamba-Kabangu JR, Staessen JA; Newer Versus Older Antihypertensive Agents in African Hypertensive Patients Trial (NOAAH) Investigators. Heart rate variability on antihypertensive drugs in black patients living in sub-Saharan Africa. Blood Press. 2014 Jun;23(3):174-80. doi: 10.3109/08037051.2013.836810. Epub 2013 Sep 25.

Reference Type DERIVED
PMID: 24066715 (View on PubMed)

Odili AN, Ezeala-Adikaibe B, Ndiaye MB, Anisiuba BC, Kamdem MM, Ijoma CK, Kaptue J, Boombhi HJ, Kolo PM, Shu EN, Thijs L, Staessen JA, Omotoso BA, Kingue S, Ba SA, Lemogoum D, M'Buyamba-Kabangu JR, Ulasi II. Progress report on the first sub-Saharan Africa trial of newer versus older antihypertensive drugs in native black patients. Trials. 2012 May 17;13:59. doi: 10.1186/1745-6215-13-59.

Reference Type DERIVED
PMID: 22594907 (View on PubMed)

Other Identifiers

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NOAAH version 5.0.2

Identifier Type: -

Identifier Source: org_study_id