The Precision Hypertension Care Study

• Status: Completed
• Trial end date: 2021-06-11
• Target enrollment: 0
• Participant gender: All

Summary

The PHYSIC study aims to investigate the potential for precision medicine in the treatment of high blood pressure.

It is a double-blind, randomized, repeated cross-over trial with six treatment periods: four classes of blood pressure-lowering drugs where treatment with two classes are repeated for each patient. The classes of blood pressure-lowering drugs to be tested are a diuretic, a calcium channel blocker, an ACE-inhibitor and an angiotensin receptor blocker.

• Phase: Phase 4
• Accepts Healthy Volunteers?: No

Details

• Lead Sponsor: Uppsala University
• Treatments: Amlodipine; Candesartan; Candesartan cilexetil; Lisinopril

Criteria

Inclusion Criteria:

1. Male or female aged ≥40 years and ≤75 years

2. Previously diagnosed with hypertension with systolic blood pressure between 140 and 159 mm Hg within five years prior to the start of the trial.

3. Pharmacologically untreated or using blood pressure-lowering monotherapy at Visit 1. No blood pressure-lowering medication taken during the placebo run-in period.

4. Office systolic blood pressure between 140 and 179 mm Hg and diastolic blood pressure at or below 109 mm Hg at Visit 2.

5. Patients must give informed consent to participate in the study.

Exclusion Criteria:

1. Medical history, clinical signs or laboratory results indicating secondary hypertension, including primary aldosteronism or renal artery stenosis

2. Evidence of serious hematological, respiratory immunological, renal, hepatic, gastrointestinal, endocrinological, metabolic, neurologic, malignant, psychiatric or other diseases as revealed by medical history, physical examination and/or laboratory assessments.

3. Active gout

4. Previous or present arterial occlusive diseases such as myocardial infarction (MI), stroke or acute arterial insufficiency (unstable angina pectoris or transient ischemic attacks, (TIA)) or heart failure (NYHA class III or IV, or left ventricular systolic dysfunction irrespectively of function class).

5. Moderate or severe aortic or mitral insufficiency.

6. Renal failure, including hemo-dialysis or kidney transplant/s.

7. Atrial fibrillation in need of rate control.

8. Symptomatic hypotension, defined as weakness or syncope upon rising to an erect position associated with a decrease in systolic blood pressure.

9. Diabetes requiring insulin or oral glucose-lowering drugs.

10. Any history of serious abnormal drug reaction to active or inactive compounds in the study drugs, including angioedema.

11. Any condition associated with poor compliance including alcoholism or drug dependence.

12. Patients who will not comply with the study protocol as judged by the Investigator.

13. Women who are pregnant or lactating or not using appropriate contraception for at least 3 months prior to visit 1. Acceptable contraceptive methods are: combined (estrogen and progesterone containing) hormonal contraception associated with inhibition of ovulation (oral, intravaginal, transdermal), progesterone-only hormonal contraception associated with inhibition of ovulation (oral, injectable, implantable), intrauterine device, intrauterine hormone-releasing system, bilateral tubal occlusion and vasectomised partner.

14. Continuous use of concomitant medication that can interfere with study medication, i.e. digitalis glucosides, sotalol, cholestyramine, colestipol, NSAID, lithium, carbamazepine, CYP3A4-inhibitors, CYP3A4-inducers, dantrolene, diuretics, aliskiren, gold, sympathomimetics, tricyclic antidepressants, antipsychotics, anaesthetics and potassium supplements.

15. Clinical laboratory assessment outside normal range at visit 1 and judged clinically significant by the Investigator.

16. Previous randomization in present study