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Telmisartan, Amlodipine and Flow Mediated Dilation (TEAMSTAprotect)

Primary Purpose

Hypertension

Status
Unknown status
Phase
Phase 4
Locations
Germany
Study Type
Interventional
Intervention
Telmisartan
Amlodipine
Olmesartan medoxomil
Hydrochlorothiazide
Sponsored by
Johannes Gutenberg University Mainz
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Hypertension focused on measuring FMD, hypertension, Telmisartan, Amlodipine

Eligibility Criteria

35 Years - undefined (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • Ability to provide written informed consent in accordance with Good Clinical Practice and local legislation.
  • Age 35 and older.
  • Male and female, treated and treatment-naive patients with uncontrolled hypertension (defined as 20/10 mmHg above target BP of <140/90 mmHg [<130/80 mmHg for renally impaired and/ or diabetics patients])
  • Male and female treated patients with controlled hypertension (defined as target BP < 140/90 mmHg [ < 130/80 mmHg for renally impaired and/ or diabetics patients])
  • > 3 cardiovascular risk factors CVRFs and/or metabolic syndrome and/or diabetes mellitus and/or end organ damage

Exclusion Criteria:

  1. Pretreatment with Telmisartan within the last 3 months.
  2. Pretreatment with Amlodipine, Diuretics and AT1Blocker/ACEInhibitor within the last 3 months
  3. Myocardial infarction within last 6 months.
  4. Previous stroke or hemodynamically relevant stenosis of carotic arteria (>70%).
  5. Previous cardial or peripheral bypass surgery within last 6 months.
  6. PAD stadium III - IV n.F.
  7. Chronic heart failure NYHA III- IV.
  8. Unstable angina.
  9. Known intolerance to angiotensin receptor blockers, diuretics or dihydropyridine calcium channel blocker.
  10. Pre-menopausal women (last menstruation ≤1 year prior to signing informed consent) who:

    1. are not surgically sterile; or
    2. are nursing, or
    3. are pregnant, or
    4. are of childbearing potential and are NOT practicing acceptable methods of birth control, or do NOT plan to continue practicing an acceptable method throughout the trial.

      The only acceptable methods of birth control are:

    5. Intra-Uterine Device (IUD)
    6. Oral
    7. implantable or injectable contraceptives
    8. Estrogen patch
    9. Hormonal birth control should have been in use for at least three months before the study and continue at least until the next menstrual period after completing the study
  11. Night shift workers who routinely sleep during the daytime and whose work hours include midnight to 4:00 a.m.
  12. Known or suspected secondary hypertension (e.g., renal artery stenosis or phaeochromocytoma)
  13. Mean in-clinic seated cuff SBP ≥180 mmHg and/or DBP ≥110 mmHg
  14. Renal dysfunction as defined by the following laboratory parameters:
  15. Serum creatinine >3.0 mg/dL (or >265 μmol/L) and/or known estimated creatinine clearance of <30 ml/min and/or clinical markers of severe renal impairment.
  16. Bilateral renal artery stenosis, renal artery stenosis in a solitary kidney, post-renal transplant patients or patients with only one kidney
  17. Clinically relevant hypokalemia or hyperkalemia (i.e., <3.0 or >5.5 mEq/L, may be rechecked for suspected error in result)
  18. Uncorrected sodium or volume depletion
  19. Primary aldosteronism
  20. Hereditary fructose intolerance
  21. Biliary obstructive disorders (e.g., cholestasis) or hepatic insufficiency
  22. Clinically significant ventricular tachycardia, atrial fibrillation, atrial flutter or other clinically relevant cardiac arrhythmias as determined by the Investigator
  23. Hypertrophic obstructive cardiomyopathy, severe obstructive coronary artery disease, aortic stenosis, hemodynamically relevant stenosis of the aortic or mitral valve
  24. Patients whose diabetes has not been stable and controlled for at least the past three months as defined by an HbA1C ≥10%
  25. Patients who have previously experienced symptoms characteristic of angioedema during treatment with ACE inhibitors or angiotensin-II receptor antagonists
  26. History of drug or alcohol abuses within six months prior to signing the informed consent form
  27. Concomitant administration of any medications known to affect BP, except medications allowed by the protocol
  28. Any investigational drug therapy within one month of signing the informed consent
  29. Known contraindication to any component of the trial drugs (telmisartan, amlodipine, olmesartan, hydrochlorothiazide)
  30. History of non-compliance or inability to comply with prescribed medications or protocol procedures
  31. Any other clinical condition which, in the opinion of the investigator, would not allow safe completion of the protocol and safe administration of the trial medication

Sites / Locations

  • Universitätsmedizin Mainz

Arms of the Study

Arm 1

Arm 2

Arm Type

Active Comparator

Active Comparator

Arm Label

T/A

O/HCT

Arm Description

Telmisartan + Amlopidpine

Olmesartan + Hydrochlorothiazide

Outcomes

Primary Outcome Measures

FMD flow mediated dilation
The overall mean improvement following 26 weeks of treatment in FMD as measured by the change from Visit 2 for T80/A10 is equal to O40/H25.
FMD
The overall mean improvement following 26 weeks of treatment in FMD as measured by the change from Visit 2 for T80/A10 is equal to O40/H25.

Secondary Outcome Measures

Echogenicity
To investigate the effects of T and A vs O and HCTZ on grayscale median of carotid atherosclerotic plaques
arterial stiffness
To investigate the effects of T and A vs O and HCTZ in reducing arterial stiffness
arterial stiffness
To investigate the effects of T and A vs O and HCTZ in reducing arterial stiffness
Echogenicity
To investigate the effects of T and A vs O and HCTZ on grayscale median of carotid atherosclerotic plaques

Full Information

First Posted
August 4, 2010
Last Updated
July 11, 2011
Sponsor
Johannes Gutenberg University Mainz
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1. Study Identification

Unique Protocol Identification Number
NCT01180205
Brief Title
Telmisartan, Amlodipine and Flow Mediated Dilation
Acronym
TEAMSTAprotect
Official Title
A TElmisartan and AMlodipine STudy to Assess the Cardiovascular PROTECTive Effects as Measured by Endothelial Dysfunction in Hypertensive at Risk Patients Beyond Blood Pressure
Study Type
Interventional

2. Study Status

Record Verification Date
April 2010
Overall Recruitment Status
Unknown status
Study Start Date
August 2010 (undefined)
Primary Completion Date
October 2011 (Anticipated)
Study Completion Date
October 2011 (Anticipated)

3. Sponsor/Collaborators

Name of the Sponsor
Johannes Gutenberg University Mainz

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
To show superior effects of the combination Telmisartan and Amlodipine (T and A) vs Olmesartan and Hydrochlorothiazide (O and HCTZ) on endothelial dysfunction as measured by flow mediated dilation (FMD) in hypertensive at risk patients beyond bloodpressure BP (equal BP in both arms; target BP <140/90 mmHg (<130/80 mmHg for renally impaired and/ or diabetic patients). To investigate the effects of T and A vs O and HCTZ in reducing arterial stiffness and carotid atherosclerotic plaques.
Detailed Description
This is a Phase IV, randomised, double-blind, forced- titration, active controlled, mono-center study to primarily compare the effects on endothelial function of the combination of telmisartan and amlodipine versus olmesartan and hydrochlorothiazide in hypertensive patients at risk beyond blood pressure. Additionally, key secondary endpoints for this trial are the changes in plaque and intima media complex echogenicity and the change in arterial stiffness after 26 weeks of treatment. 576 patients will be included in the study after a screening period of two weeks and then randomised in one of the two treatment groups. Pretreatment with ARBs, ACE-Inhibitors, amlodipine and diuretics will be stopped last day before visit 2. At visit 2 the treatment with either telmisartan and amlodipine or olmesartan and hydrochlorothiazide starts, so that no medication is stopped without having been replaced by the study medication. After two weeks treatment all patients will be up-titrated and having the maintenance dose for the following 24 weeks. The trial will be performed at one center in Germany with access to patients with hypertension. Patients will be recruited from the Department of Cardiology of the university Mainz. There will be a promotion flyer and an information booklet about the study for cardiologists practicising near Mainz, who like to sent their patient to the study center. Sponsor of the trial is the university Mainz. Stefan Blankenberg, MD has been designated as Principal Investigator for this national, mono-center trial. The study will be completed when the last patient had his last visit and the telephone follow - up two weeks later will be performed. This latest patient contact is defined as end of trial.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Hypertension
Keywords
FMD, hypertension, Telmisartan, Amlodipine

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 4
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
576 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
T/A
Arm Type
Active Comparator
Arm Description
Telmisartan + Amlopidpine
Arm Title
O/HCT
Arm Type
Active Comparator
Arm Description
Olmesartan + Hydrochlorothiazide
Intervention Type
Drug
Intervention Name(s)
Telmisartan
Other Intervention Name(s)
MICARDIS® (Telmisartan)
Intervention Description
Telmisartan (80 mg ,Tablets, QD, p.o., 26 weeks)
Intervention Type
Drug
Intervention Name(s)
Amlodipine
Other Intervention Name(s)
Norvasc
Intervention Description
Amlodpine 5 mg po 14 days, the forced - titration to 10 mg po for 24 weeks
Intervention Type
Drug
Intervention Name(s)
Olmesartan medoxomil
Other Intervention Name(s)
Olmetec
Intervention Description
Olmesartan 40 mg po for 26 weeks
Intervention Type
Drug
Intervention Name(s)
Hydrochlorothiazide
Intervention Description
HCT 12,5 mg po for 14 days, then 25 mg po for 24 weeks
Primary Outcome Measure Information:
Title
FMD flow mediated dilation
Description
The overall mean improvement following 26 weeks of treatment in FMD as measured by the change from Visit 2 for T80/A10 is equal to O40/H25.
Time Frame
baseline
Title
FMD
Description
The overall mean improvement following 26 weeks of treatment in FMD as measured by the change from Visit 2 for T80/A10 is equal to O40/H25.
Time Frame
after 26 weeks
Secondary Outcome Measure Information:
Title
Echogenicity
Description
To investigate the effects of T and A vs O and HCTZ on grayscale median of carotid atherosclerotic plaques
Time Frame
baseline
Title
arterial stiffness
Description
To investigate the effects of T and A vs O and HCTZ in reducing arterial stiffness
Time Frame
baseline
Title
arterial stiffness
Description
To investigate the effects of T and A vs O and HCTZ in reducing arterial stiffness
Time Frame
after 26 weeks
Title
Echogenicity
Description
To investigate the effects of T and A vs O and HCTZ on grayscale median of carotid atherosclerotic plaques
Time Frame
after 26 weeks

10. Eligibility

Sex
All
Minimum Age & Unit of Time
35 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Ability to provide written informed consent in accordance with Good Clinical Practice and local legislation. Age 35 and older. Male and female, treated and treatment-naive patients with uncontrolled hypertension (defined as 20/10 mmHg above target BP of <140/90 mmHg [<130/80 mmHg for renally impaired and/ or diabetics patients]) Male and female treated patients with controlled hypertension (defined as target BP < 140/90 mmHg [ < 130/80 mmHg for renally impaired and/ or diabetics patients]) > 3 cardiovascular risk factors CVRFs and/or metabolic syndrome and/or diabetes mellitus and/or end organ damage Exclusion Criteria: Pretreatment with Telmisartan within the last 3 months. Pretreatment with Amlodipine, Diuretics and AT1Blocker/ACEInhibitor within the last 3 months Myocardial infarction within last 6 months. Previous stroke or hemodynamically relevant stenosis of carotic arteria (>70%). Previous cardial or peripheral bypass surgery within last 6 months. PAD stadium III - IV n.F. Chronic heart failure NYHA III- IV. Unstable angina. Known intolerance to angiotensin receptor blockers, diuretics or dihydropyridine calcium channel blocker. Pre-menopausal women (last menstruation ≤1 year prior to signing informed consent) who: are not surgically sterile; or are nursing, or are pregnant, or are of childbearing potential and are NOT practicing acceptable methods of birth control, or do NOT plan to continue practicing an acceptable method throughout the trial. The only acceptable methods of birth control are: Intra-Uterine Device (IUD) Oral implantable or injectable contraceptives Estrogen patch Hormonal birth control should have been in use for at least three months before the study and continue at least until the next menstrual period after completing the study Night shift workers who routinely sleep during the daytime and whose work hours include midnight to 4:00 a.m. Known or suspected secondary hypertension (e.g., renal artery stenosis or phaeochromocytoma) Mean in-clinic seated cuff SBP ≥180 mmHg and/or DBP ≥110 mmHg Renal dysfunction as defined by the following laboratory parameters: Serum creatinine >3.0 mg/dL (or >265 μmol/L) and/or known estimated creatinine clearance of <30 ml/min and/or clinical markers of severe renal impairment. Bilateral renal artery stenosis, renal artery stenosis in a solitary kidney, post-renal transplant patients or patients with only one kidney Clinically relevant hypokalemia or hyperkalemia (i.e., <3.0 or >5.5 mEq/L, may be rechecked for suspected error in result) Uncorrected sodium or volume depletion Primary aldosteronism Hereditary fructose intolerance Biliary obstructive disorders (e.g., cholestasis) or hepatic insufficiency Clinically significant ventricular tachycardia, atrial fibrillation, atrial flutter or other clinically relevant cardiac arrhythmias as determined by the Investigator Hypertrophic obstructive cardiomyopathy, severe obstructive coronary artery disease, aortic stenosis, hemodynamically relevant stenosis of the aortic or mitral valve Patients whose diabetes has not been stable and controlled for at least the past three months as defined by an HbA1C ≥10% Patients who have previously experienced symptoms characteristic of angioedema during treatment with ACE inhibitors or angiotensin-II receptor antagonists History of drug or alcohol abuses within six months prior to signing the informed consent form Concomitant administration of any medications known to affect BP, except medications allowed by the protocol Any investigational drug therapy within one month of signing the informed consent Known contraindication to any component of the trial drugs (telmisartan, amlodipine, olmesartan, hydrochlorothiazide) History of non-compliance or inability to comply with prescribed medications or protocol procedures Any other clinical condition which, in the opinion of the investigator, would not allow safe completion of the protocol and safe administration of the trial medication
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Stefan Blankenberg, Prof.Dr.med.
Organizational Affiliation
Universitätsmedizin Mainz, II.Medizinische Klinik
Official's Role
Principal Investigator
Facility Information:
Facility Name
Universitätsmedizin Mainz
City
Mainz
State/Province
Rheinland-Pfalz
ZIP/Postal Code
55131
Country
Germany

12. IPD Sharing Statement

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Telmisartan, Amlodipine and Flow Mediated Dilation

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