Cardiovascular DiseasesNCT00005332
Antihypertensive Drug/Gene Interactions and CV Events
An observational study of Cardiovascular Diseases and Heart Diseases, run by University of Washington.
Trial summary
To investigate drug-gene interactions on the incidence of non-fatal myocardial infarction and stroke for hypertensive patients. Read more about this study
- Who is it for?
- Ages 30 to 79 years
- Conditions the study is for
- Cardiovascular Diseases, Heart Diseases, Myocardial Infarction
- How many people
- Not given
- Where
- No sites listed yet
- Study dates
- Sep 1991to Aug 2007
- Phase
- Observational
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 30 to 79 years
- All sexes
- No healthy volunteers
- Adult, Older adult
No eligibility criteria
About this study
To investigate drug-gene interactions on the incidence of non-fatal myocardial infarction and stroke for hypertensive patients.
Read the detailed description
BACKGROUND:
The original study "Calcium-Channel Blockers and Primary Prevention of Coronary Heart Disease" was conducted from 1991 to 1995 and was designed to determine whether the calcium-channel blockers reduced the incidence of myocardial infarction (MI) in patients with hypertension. Secondary aims included the evaluation of the relative efficacy and safety of other major drug classes, including ACE inhibitors, beta-blockers, and alpha blockers. The study originated to answer questions concerning the 1988 recommendations from the Joint National Committee on Detection, Evaluation, and Treatment of High Blood Pressure (JNC V). The 1988 recommendations from the Joint National Committee revolutionized the step-care approach to the treatment of hypertension: the calcium- channel blockers, a then new class of agents, were included as first-line agents. That they lowered blood pressure was clear. But no randomized trial had yet evaluated their safety and efficacy in terms of the clinical endpoints of stroke and coronary heart disease. Because the results of previous randomized trials suggested that the treatment of hypertension did not reduce the incidence of coronary heart disease, the study was designed to answer that question.
In 1995, the study was renewed as "Antihypertensive Medications, MI and Stroke" and was designed to to determine whether calcium-channel blockers increased the risk of stroke among hypertensive patients and whether individual calcium-channel blockers representing the three major subclasses increased the risks of MI and of the combined endpoint of MI and stroke in patients with hypertension.
DESIGN NARRATIVE:
The study has a case-control design. Data collected from the Group Health Cooperative (GHC) computerized files were used to identify potential cases: all treated hypertensive patients, aged 30 to 79 years, were eligible as cases if, according to WHO criteria, they presented with an incident, fatal or non-fatal MI. A random sample of members listed in the GHC enrollment files served as the source of potential controls. Review of the outpatient medical records ensured that all study subjects met the same entrance criteria. The effort also secured information about blood pressures, duration of hypertension, and past medical history. A telephone interview provided information about other potential confounders, including smoking, diet, and physical activity. The GHC computerized pharmacy records, a database of all prescriptions filled by enrollees, served as the primary source of information about the use of calcium-channel blockers. Frequency matching controlled for the potential confounding effects of age and year of presentation, and data analysis involved logistic regression.
The study has been renewed twice. The first renewal was for an additional five years through May, 2000 in order to identify an estimated additional 1,007 stroke cases, an additional 1,020 MI cases, and an additional 2,500 controls. The second renewal was through August, 2005 to determine antihypertensive drug/gene interactions and cardiovascular events. The ongoing second renewal focuses on drug-gene interactions on the incidence of non-fatal myocardial infarction and stroke for hypertensive patients, emphasizing (1) the alpha adducin polymorphism and diuretic use; (2) the beta-2 adrenergic receptor-27 (B2AR27) polymorphism and beta-blockers; and (3) the ACE insertion/deletion polymorphism and the ACE inhibitor use. The study also assesses other potential gene-drug interactions with the G-protein beta-3 subunit (GB3) polymorphism, B2AR-16 polymorphism, the amiloride-sensitive epithelial sodium channel, and the angiotensinogen Met235Thr polymorphism. In addition, for fatal cases DNA extracted from surgical or pathological specimens will be used to assess genotypes.
- Conditions
- Cardiovascular Diseases, Heart Diseases, Myocardial Infarction, Hypertension, Cerebrovascular Accident
- Medical subject headings
- Cardiovascular Diseases, Heart Diseases, Myocardial Infarction, Hypertension, Stroke
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted26 May 2000 (estimated)
- Study startSep 1991
- Primary completionAug 2007
- Study completionAug 2007
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (33)Papers the sponsor has linked to this study.
- Other trials for Cardiovascular DiseasesStudies of the same condition, open and under way.
- More trials run by University of WashingtonThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Observational
Sponsor and investigators
- Lead sponsor
- University of Washington
- Sponsor type
- University, hospital or other
- Collaborators
- National Heart, Lung, and Blood Institute (NHLBI)
- Responsible party
- Principal investigator, Bruce Psaty, University of Washington
- Investigators
- Bruce Psaty, University of Washington
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT00005332
- Sponsor's protocol ID
- 4183
- Other IDs
- R01HL043201
- Status last verified
- May 2018
- First submitted
- 25 May 2000
- Last updated
- 7 May 2018
- Results posted
- No
Publications
Psaty BM, Heckbert SR, Atkins D, Siscovick DS, Koepsell TD, Wahl PW, Longstreth WT Jr, Weiss NS, Wagner EH, Prentice R, et al. A review of the association of estrogens and progestins with cardiovascular disease in postmenopausal women. Arch Intern Med. 1993 Jun 28;153(12):1421-7.
PubMed 8512434Psaty BM, Furberg CD. Clinical implications of the World Health Organization-International Society of Hypertension statement on calcium antagonists. J Hypertens. 1997 Nov;15(11):1197-200. doi: 10.1097/00004872-199715110-00001.
PubMed 9383166Lahad A, Heckbert SR, Koepsell TD, Psaty BM, Patrick DL. Hostility, aggression and the risk of nonfatal myocardial infarction in postmenopausal women. J Psychosom Res. 1997 Aug;43(2):183-95. doi: 10.1016/s0022-3999(96)00369-8.
PubMed 9278907Heckbert SR, Weiss NS, Koepsell TD, Lemaitre RN, Smith NL, Siscovick DS, Lin D, Psaty BM. Duration of estrogen replacement therapy in relation to the risk of incident myocardial infarction in postmenopausal women. Arch Intern Med. 1997 Jun 23;157(12):1330-6.
PubMed 9201007Psaty BM, Smith NL, Siscovick DS, Koepsell TD, Weiss NS, Heckbert SR, Lemaitre RN, Wagner EH, Furberg CD. Health outcomes associated with antihypertensive therapies used as first-line agents. A systematic review and meta-analysis. JAMA. 1997 Mar 5;277(9):739-45.
PubMed 9042847Lahad A, Heckbert SR, Patrick DL, Psaty BM. Hostility, aggression and the association with hypertension in post-menopausal women. J Hum Hypertens. 1996 Sep;10 Suppl 3:S115-21.
PubMed 8872841Psaty BM, Siscovick DS, Weiss NS, Koepsell TD, Rosendaal FR, Lin D, Heckbert SR, Wagner EH, Furberg CD. Hypertension and outcomes research. From clinical trials to clinical epidemiology. Am J Hypertens. 1996 Feb;9(2):178-83. doi: 10.1016/0895-7061(96)00015-5.
PubMed 8924268Lemaitre RN, Heckbert SR, Psaty BM, Siscovick DS. Leisure-time physical activity and the risk of nonfatal myocardial infarction in postmenopausal women. Arch Intern Med. 1995 Nov 27;155(21):2302-8.
PubMed 7487254Psaty BM, Heckbert SR, Koepsell TD, Siscovick DS, Raghunathan TE, Weiss NS, Rosendaal FR, Lemaitre RN, Smith NL, Wahl PW, et al. The risk of myocardial infarction associated with antihypertensive drug therapies. JAMA. 1995 Aug 23-30;274(8):620-5.
PubMed 7637142Psaty BM, Heckbert SR, Atkins D, Lemaitre R, Koepsell TD, Wahl PW, Siscovick DS, Wagner EH. The risk of myocardial infarction associated with the combined use of estrogens and progestins in postmenopausal women. Arch Intern Med. 1994 Jun 27;154(12):1333-9.
PubMed 8002685Au DH, Lemaitre RN, Curtis JR, Smith NL, Psaty BM. The risk of myocardial infarction associated with inhaled beta-adrenoceptor agonists. Am J Respir Crit Care Med. 2000 Mar;161(3 Pt 1):827-30. doi: 10.1164/ajrccm.161.3.9904006.
PubMed 10712329Klungel OH, Kaplan RC, Heckbert SR, Smith NL, Lemaitre RN, Longstreth WT Jr, Leufkens HG, de Boer A, Psaty BM. Control of blood pressure and risk of stroke among pharmacologically treated hypertensive patients. Stroke. 2000 Feb;31(2):420-4. doi: 10.1161/01.str.31.2.420.
PubMed 10657416Kaplan RC, Psaty BM, Heckbert SR, Smith NL, Lemaitre RN. Blood pressure level and incidence of myocardial infarction among patients treated for hypertension. Am J Public Health. 1999 Sep;89(9):1414-7. doi: 10.2105/ajph.89.9.1414.
PubMed 10474562Psaty BM, Weiss NS, Furberg CD, Koepsell TD, Siscovick DS, Rosendaal FR, Smith NL, Heckbert SR, Kaplan RC, Lin D, Fleming TR, Wagner EH. Surrogate end points, health outcomes, and the drug-approval process for the treatment of risk factors for cardiovascular disease. JAMA. 1999 Aug 25;282(8):786-90. doi: 10.1001/jama.282.8.786. No abstract available.
PubMed 10463718Psaty BM, Boineau R, Kuller LH, Luepker RV. The potential costs of upcoding for heart failure in the United States. Am J Cardiol. 1999 Jul 1;84(1):108-9, A9. doi: 10.1016/s0002-9149(99)00205-2.
PubMed 10404865
Study at a glance
From the registry record, last updated by the sponsor on 7 May 2018. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Antihypertensive Drug/Gene Interactions and CV Events
- ClinicalTrials.gov ID
- NCT00005332
- Acronym / sponsor ID
- 4183
- Conditions
- Cardiovascular Diseases, Heart Diseases, Myocardial Infarction, Hypertension, Cerebrovascular Accident
- Study type
- Observational
- Recruitment status
- Completed
- Lead sponsor
- University of WashingtonUniversity, hospital or other
- Collaborators
- National Heart, Lung, and Blood Institute (NHLBI)
- Study start
- Sep 1991
- Primary completion
- Aug 2007 (actual)
- Study completion
- Aug 2007 (actual)
- First posted
- 26 May 2000 (estimated)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
To investigate drug-gene interactions on the incidence of non-fatal myocardial infarction and stroke for hypertensive patients.
Detailed description
BACKGROUND:
The original study "Calcium-Channel Blockers and Primary Prevention of Coronary Heart Disease" was conducted from 1991 to 1995 and was designed to determine whether the calcium-channel blockers reduced the incidence of myocardial infarction (MI) in patients with hypertension. Secondary aims included the evaluation of the relative efficacy and safety of other major drug classes, including ACE inhibitors, beta-blockers, and alpha blockers. The study originated to answer questions concerning the 1988 recommendations from the Joint National Committee on Detection, Evaluation, and Treatment of High Blood Pressure (JNC V). The 1988 recommendations from the Joint National Committee revolutionized the step-care approach to the treatment of hypertension: the calcium- channel blockers, a then new class of agents, were included as first-line agents. That they lowered blood pressure was clear. But no randomized trial had yet evaluated their safety and efficacy in terms of the clinical endpoints of stroke and coronary heart disease. Because the results of previous randomized trials suggested that the treatment of hypertension did not reduce the incidence of coronary heart disease, the study was designed to answer that question.
In 1995, the study was renewed as "Antihypertensive Medications, MI and Stroke" and was designed to to determine whether calcium-channel blockers increased the risk of stroke among hypertensive patients and whether individual calcium-channel blockers representing the three major subclasses increased the risks of MI and of the combined endpoint of MI and stroke in patients with hypertension.
DESIGN NARRATIVE:
The study has a case-control design. Data collected from the Group Health Cooperative (GHC) computerized files were used to identify potential cases: all treated hypertensive patients, aged 30 to 79 years, were eligible as cases if, according to WHO criteria, they presented with an incident, fatal or non-fatal MI. A random sample of members listed in the GHC enrollment files served as the source of potential controls. Review of the outpatient medical records ensured that all study subjects met the same entrance criteria. The effort also secured information about blood pressures, duration of hypertension, and past medical history. A telephone interview provided information about other potential confounders, including smoking, diet, and physical activity. The GHC computerized pharmacy records, a database of all prescriptions filled by enrollees, served as the primary source of information about the use of calcium-channel blockers. Frequency matching controlled for the potential confounding effects of age and year of presentation, and data analysis involved logistic regression.
The study has been renewed twice. The first renewal was for an additional five years through May, 2000 in order to identify an estimated additional 1,007 stroke cases, an additional 1,020 MI cases, and an additional 2,500 controls. The second renewal was through August, 2005 to determine antihypertensive drug/gene interactions and cardiovascular events. The ongoing second renewal focuses on drug-gene interactions on the incidence of non-fatal myocardial infarction and stroke for hypertensive patients, emphasizing (1) the alpha adducin polymorphism and diuretic use; (2) the beta-2 adrenergic receptor-27 (B2AR27) polymorphism and beta-blockers; and (3) the ACE insertion/deletion polymorphism and the ACE inhibitor use. The study also assesses other potential gene-drug interactions with the G-protein beta-3 subunit (GB3) polymorphism, B2AR-16 polymorphism, the amiloride-sensitive epithelial sodium channel, and the angiotensinogen Met235Thr polymorphism. In addition, for fatal cases DNA extracted from surgical or pathological specimens will be used to assess genotypes.
Study design
Who may qualify
- Ages
- 30 to 79 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Primary outcome
Not reported in the source record.
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 7 May 2018.
- Background: PubMed 8512434Psaty BM, Heckbert SR, Atkins D, Siscovick DS, Koepsell TD, Wahl PW, Longstreth WT Jr, Weiss NS, Wagner EH, Prentice R, et al. A review of the association of estrogens and progestins with cardiovascular disease in postmenopausal women. Arch Intern Med. 1993 Jun 28;153(12):1421-7.
- Background: PubMed 9383166Psaty BM, Furberg CD. Clinical implications of the World Health Organization-International Society of Hypertension statement on calcium antagonists. J Hypertens. 1997 Nov;15(11):1197-200. doi: 10.1097/00004872-199715110-00001.
- Background: PubMed 9278907Lahad A, Heckbert SR, Koepsell TD, Psaty BM, Patrick DL. Hostility, aggression and the risk of nonfatal myocardial infarction in postmenopausal women. J Psychosom Res. 1997 Aug;43(2):183-95. doi: 10.1016/s0022-3999(96)00369-8.
- Background: PubMed 9201007Heckbert SR, Weiss NS, Koepsell TD, Lemaitre RN, Smith NL, Siscovick DS, Lin D, Psaty BM. Duration of estrogen replacement therapy in relation to the risk of incident myocardial infarction in postmenopausal women. Arch Intern Med. 1997 Jun 23;157(12):1330-6.
- Background: PubMed 9042847Psaty BM, Smith NL, Siscovick DS, Koepsell TD, Weiss NS, Heckbert SR, Lemaitre RN, Wagner EH, Furberg CD. Health outcomes associated with antihypertensive therapies used as first-line agents. A systematic review and meta-analysis. JAMA. 1997 Mar 5;277(9):739-45.
- Background: PubMed 8872841Lahad A, Heckbert SR, Patrick DL, Psaty BM. Hostility, aggression and the association with hypertension in post-menopausal women. J Hum Hypertens. 1996 Sep;10 Suppl 3:S115-21.
- Background: PubMed 8924268Psaty BM, Siscovick DS, Weiss NS, Koepsell TD, Rosendaal FR, Lin D, Heckbert SR, Wagner EH, Furberg CD. Hypertension and outcomes research. From clinical trials to clinical epidemiology. Am J Hypertens. 1996 Feb;9(2):178-83. doi: 10.1016/0895-7061(96)00015-5.
- Background: PubMed 7487254Lemaitre RN, Heckbert SR, Psaty BM, Siscovick DS. Leisure-time physical activity and the risk of nonfatal myocardial infarction in postmenopausal women. Arch Intern Med. 1995 Nov 27;155(21):2302-8.
- Background: PubMed 7637142Psaty BM, Heckbert SR, Koepsell TD, Siscovick DS, Raghunathan TE, Weiss NS, Rosendaal FR, Lemaitre RN, Smith NL, Wahl PW, et al. The risk of myocardial infarction associated with antihypertensive drug therapies. JAMA. 1995 Aug 23-30;274(8):620-5.
- Background: PubMed 8002685Psaty BM, Heckbert SR, Atkins D, Lemaitre R, Koepsell TD, Wahl PW, Siscovick DS, Wagner EH. The risk of myocardial infarction associated with the combined use of estrogens and progestins in postmenopausal women. Arch Intern Med. 1994 Jun 27;154(12):1333-9.
- Background: PubMed 10712329Au DH, Lemaitre RN, Curtis JR, Smith NL, Psaty BM. The risk of myocardial infarction associated with inhaled beta-adrenoceptor agonists. Am J Respir Crit Care Med. 2000 Mar;161(3 Pt 1):827-30. doi: 10.1164/ajrccm.161.3.9904006.
- Background: PubMed 10657416Klungel OH, Kaplan RC, Heckbert SR, Smith NL, Lemaitre RN, Longstreth WT Jr, Leufkens HG, de Boer A, Psaty BM. Control of blood pressure and risk of stroke among pharmacologically treated hypertensive patients. Stroke. 2000 Feb;31(2):420-4. doi: 10.1161/01.str.31.2.420.
Related trials for Cardiovascular Diseases
Active, not recruitingObservational study
Gulf Long-Term Follow-Up Study
Cardiovascular Disease, Hematologic Diseases
Active, not recruitingObservational study
The CoPenHagen PREeClampsia and cardIOvascUlar diSease Study
Pre-Eclampsia, Atherosclerosis
Recruiting
CT Stress Myocardial Perfusion, Fractional Flow Reserve and Angiography in Patients With Stable Chest Pain Syndromes
Coronary Artery Disease, Chest Syndrome
Enrolling by invitation
The DANE-HEART Trial - Computed Tomography Coronary Angiography for Primary Prevention
Coronary Atherosclerosis and Other Heart Disease, Cardiovascular Diseases
Active, not recruitingPhase 3
A Study of Inclisiran to Prevent Cardiovascular Events in High-risk Primary Prevention Patients.
Primary Prevention of Atherosclerotic Cardiovascular Disease
Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Bruce Psaty
University of Washington
Questions about this trial
What is this clinical trial studying?
An observational study of Cardiovascular Diseases and Heart Diseases, run by University of Washington.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 7 May 2018. Status can change between updates, so confirm with the study contact before making plans.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT00005332, which also lists 33 linked publications.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 7 May 2018; AzTrials last refreshed its copy on 6 Nov 2026.