A randomized controlled crossover trial evaluating differential responses to antihypertensive drugs (used as mono- or dual therapy) on the basis of ethnicity: The comparIsoN oF Optimal Hypertension RegiMens; part of the Ancestry Informative Markers in HYpertension program-AIM-HY INFORM trial

Am Heart J. 2018 Oct:204:102-108. doi: 10.1016/j.ahj.2018.05.006. Epub 2018 May 20.

Abstract

Background: Ethnicity, along with a variety of genetic and environmental factors, is thought to influence the efficacy of antihypertensive therapies. Current UK guidelines use a "black versus white" approach; in doing so, they ignore the United Kingdom's largest ethnic minority: Asians from South Asia.

Study design: The primary purpose of the AIM-HY INFORM trial is to identify potential differences in response to antihypertensive drugs used as mono- or dual therapy on the basis of self-defined ethnicity. A multicenter, prospective, open-label, randomized study with 2 parallel, independent trial arms (mono- and dual therapy), AIM-HY INFORM plans to enroll a total of 1,320 patients from across the United Kingdom. Those receiving monotherapy (n = 660) will enter a 3-treatment (amlodipine 10 mg od; lisinopril 20 mg od; chlorthalidone 25 mg od), 3-period crossover, lasting 24 weeks, whereas those receiving dual therapy (n = 660) will enter a 4-treatment (amlodipine 5 mg od and lisinopril 20 mg od; amlodipine 5 mg od and chlorthalidone 25 mg od; lisinopril 20 mg od and chlorthalidone 25 mg od; amiloride 10 mg od and chlorthalidone 25 mg od), 4-period crossover, lasting 32 weeks. Equal numbers of 3 ethnic groups (white, black/black British, and Asian/Asian British) will ultimately be recruited to each of the trial arms (ie, 220 participants per ethnic group per arm). Seated, automated, unattended, office, systolic blood pressure measured 8 weeks after each treatment period begins will serve as the primary outcome measure.

Conclusion: AIM-HY INFORM is a prospective, open-label, randomized trial which aims to evaluate first- and second-line antihypertensive therapies for multiethnic populations.

Trial registration: ClinicalTrials.gov NCT02847338.

Publication types

  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Amlodipine / therapeutic use
  • Antihypertensive Agents / therapeutic use*
  • Asian People
  • Black People
  • Chlorthalidone / therapeutic use
  • Cross-Over Studies
  • Drug Administration Schedule
  • Drug Therapy, Combination
  • Hemodynamics
  • Humans
  • Hypertension / drug therapy*
  • Hypertension / ethnology*
  • Hypertension / physiopathology
  • Lisinopril / therapeutic use
  • Middle Aged
  • Prospective Studies
  • United Kingdom
  • White People
  • Young Adult

Substances

  • Antihypertensive Agents
  • Amlodipine
  • Lisinopril
  • Chlorthalidone

Associated data

  • ClinicalTrials.gov/NCT02847338