title: Rationale, design and patient baseline characteristics of OlmeSartan and calcium antagonists randomized (OSCAR) study: a study comparing the incidence of cardiovascular events between high-dose angiotensin II receptor blocker (ARB) monotherapy and combination therapy of ARB with calcium channel blocker in Japanese elderly high-risk hypertensive patients (ClinicalTrials. gov no. NCT00134160).
abstract: Higher doses of angiotensin II receptor blockers (ARBs) are expected to exert more protective effects against cardiovascular diseases. However, the significance of treatment of hypertension with high-dose ARB remains to be defined. The OlmeSartan and Calcium Antagonists Randomized (OSCAR) Study was designed to determine whether high-dose ARB monotherapy is superior to the combination therapy of ARB plus calcium channel blocker (CCB) in the prevention of cardiovascular morbidity/mortality in Japanese elderly high-risk hypertensive patients. The OSCAR study is a multicenter, active-controlled, two-arm parallel group comparison, using the prospective randomized open-blinded end-point method. In the 'Step 1' period, elderly hypertensive patients with diabetes or cardiovascular disease received monotherapy with ARB olmesartan medoxomil at a dose of 20 mg day(-1). If the target blood pressure control (less than 140/90 mm Hg) was not achieved by ARB monotherapy, the patients were randomized to receive either (1) the increased dose of olmesartan at 40 mg day(-1) (high-dose ARB monotherapy) or (2) the addition of a CCB (amlodipine or azelnidipine) to 20 mg day(-1) olmesartan (ARB plus CCB combination) in the 'Step 2' period. The follow-up duration will be 3 years. The primary end points will be the composite of fatal and non-fatal cardiovascular events, and death from any cause. Recruitment for the OSCAR study (around 1200 patients) was completed by the end of May 2007. The OSCAR study is the first large clinical trial comparing the efficacy of high-dose ARB monotherapy with that of an ARB plus CCB combination therapy in elderly high-risk hypertensive patients.
authors.affiliation: Department of Cardiovascular Medicine, Kumamoto University Graduate School of Medical Sciences, Kumamoto, Japan.
authors.forename: Hisao
authors.initials: H
authors.lastname: Ogawa
authors.forename: Shokei
authors.initials: S
authors.lastname: Kim-Mitsuyama
authors.forename: Tomio
authors.initials: T
authors.lastname: Jinnouchi
authors.forename: Kunihiko
authors.initials: K
authors.lastname: Matsui
authors.forename: Kikuo
authors.initials: K
authors.lastname: Arakawa
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D047228:Angiotensin II Type 1 Receptor Blockers / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use*; D000959:Antihypertensive Agents / Q000009:adverse effects* / Q000627:therapeutic use*; D002121:Calcium Channel Blockers / Q000009:adverse effects* / Q000627:therapeutic use*; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000517:prevention & control; D003627:Data Interpretation, Statistical; D004359:Drug Therapy, Combination; D023381:Endpoint Determination; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006973:Hypertension / Q000188:drug therapy*; D007093:Imidazoles / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use*; D007258:Informed Consent; D007564:Japan; D008297:Male; D018579:Patient Selection; D011897:Random Allocation; D016032:Randomized Controlled Trials as Topic; D012107:Research Design; D012307:Risk Factors; D018401:Sample Size; D013777:Tetrazoles / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use*
chemical_list: D047228:Angiotensin II Type 1 Receptor Blockers; D000959:Antihypertensive Agents; D002121:Calcium Channel Blockers; D007093:Imidazoles; D013777:Tetrazoles; C437965:olmesartan