Diabetes Risk Evaluation and Microalbuminuria in Saskatchewan First Nations Peoples (DREAM3)
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Purpose
This randomized controlled trial was designed to assess whether a community-based treatment strategy implemented by home care nurses would be effective in controlling hypertension in First Nations people with existing hypertension and type 2 diabetes.
| Condition | Intervention |
|---|---|
|
Hypertension Diabetes Mellitus |
Other: Nurse administered treatment algorithm |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Endpoint Classification: Safety/Efficacy Study Intervention Model: Parallel Assignment Masking: Open Label Primary Purpose: Treatment |
| Official Title: | Diabetes Risk Evaluation and Microalbuminuria in Saskatchewan First Nations Peoples |
- systolic blood pressure [ Time Frame: 12 months ] [ Designated as safety issue: No ]
- Change in diastolic blood pressure, change in urine albumin status and incidence of adverse events [ Time Frame: 12 months ] [ Designated as safety issue: Yes ]
| Enrollment: | 95 |
| Study Start Date: | September 2001 |
| Study Completion Date: | March 2003 |
| Primary Completion Date: | March 2003 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Experimental: Intervention group
A home care nurse followed a predefined treatment algorithm of pharmacologic antihypertensive therapy.
|
Other: Nurse administered treatment algorithm
Start with Irbesartan 150 mg/d; check BP in 6 wks, if BP >=130/80 mm HF, 300 mg/d irbesartan; check BP at next visit, if BP>= 130/80 mm Hg, add HCTZ 12.5 mg/d; check BP at next visit, if BP>=130/80 mm Hg, add verapamil 180 mg/d; check BP at next visit, if BP>=13/80 mm Hg, increase verapamil to 240 mg/d
|
|
No Intervention: Control group
Treatment decisions were made by each subject's primary care physician. Participants in this group received usual care.
|
Detailed Description:
Two community-based strategies for controlling hypertension in First Nations people with existing hypertension and diabetes were compared. In the intervention group, a home care nurse followed a predefined treatment algorithm of pharmacologic antihypertensive therapy. In the control group, treatment decisions were made by each subject's primary care physician. The primary outcome measure was the difference between the 2 groups in teh change in systolic blood pressure after 12 months.
Eligibility| Ages Eligible for Study: | 18 Years and older |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Age>= 18 yr
- Type 2 diabetes mellitus
- Persistent hypertension (systolic pressure >= 130 mmHg, diastolic pressure >= 80 mm Hg, or both)
Exclusion Criteria:
- use of beta blocker
- women of child-bearing age not able to use a reliable method of birth control
- Connective tissue disorder
- Severe systemic or malignant disease
- Inability to follow the protocol
- Bilateral renal artery stenosis and other causes of secondary hypertension
- Serum creatinine level > 250 micromol/L
- cerebrovascular even within 6 mo
- valvular heart disease
- unstable angina
- Myocardial infarction
- Revascularization procedure within 3 mo before study recruitment
- heart failure
- cardiac arrhythmia requiring medical treatment or heart block
- active hepatic disease
Contacts and Locations
More Information
No publications provided
| Responsible Party: | Sheldon Tobe, Principal Investigator, Sunnybrook Health Sciences Centre |
| ClinicalTrials.gov Identifier: | NCT00741702 History of Changes |
| Other Study ID Numbers: | 231-2001 |
| Study First Received: | August 25, 2008 |
| Last Updated: | May 15, 2012 |
| Health Authority: | Canada: Ethics Review Committee |
Keywords provided by Sunnybrook Health Sciences Centre:
|
Hypertension Type 2 diabetes First Nations populations |
Additional relevant MeSH terms:
|
Diabetes Mellitus Hypertension Glucose Metabolism Disorders Metabolic Diseases |
Endocrine System Diseases Vascular Diseases Cardiovascular Diseases |
ClinicalTrials.gov processed this record on June 18, 2013