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Candesartan Antihypertensive Survival Evaluation in Japan (CASE-J) Trial of Cardiovascular Events in High-Risk Hypertensive Patients

The recruitment status of this study is unknown. The completion date has passed and the status has not been verified in more than two years.
Verified April 2005 by The Japanese Society of Hypertension.
Recruitment status was:  Active, not recruiting
Information provided by:
The Japanese Society of Hypertension Identifier:
First received: July 29, 2005
Last updated: August 8, 2005
Last verified: April 2005
The purpose of this study is to compare an angiotensin II receptor antagonist (candesartan cilexetil– Blopress®) and a calcium channel blocker (amlodipine besilate– Norvasc®/Amlodin®) in terms of the incidence of cardiovascular events among high-risk hypertensive patients.

Condition Intervention Phase
Hypertension Cardiovascular Diseases Drug: Candesartan cilexetil Phase 3

Study Type: Interventional
Study Design: Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: Candesartan Antihypertensive Survival Evaluation in Japan (CASE-J) Trial of Cardiovascular Events in High-Risk Hypertensive Patients

Resource links provided by NLM:

Further study details as provided by The Japanese Society of Hypertension:

Primary Outcome Measures:
  • Sudden death: death of endogenous origin within 24 hours after acute onset
  • Cerebrovascular events: new occurrence or recurrence of a stroke or transient ischemic attack
  • Cardiac events: new occurrence, aggravation, or recurrence of heart failure, angina pectoris, or acute myocardial infarction
  • Renal dysfunction: serum creatinine ≥4.0 mg/dl, end stage renal disease, doubling of serum creatinine (however, creatinine ≤2.0 mg/dl is not regarded as an event)
  • Vascular events: new occurrence or aggravation of dissecting aneurysm of aorta, arteriosclerotic occlusion of peripheral artery

Secondary Outcome Measures:
  • All deaths
  • Involution of left ventricular hypertrophy (LVMI)
  • Proportion of the subjects who withdrew from the allocated treatment

Estimated Enrollment: 3200
Study Start Date: September 2001
Estimated Study Completion Date: December 2005
Detailed Description:

Hypertension continues to be a major public health issue in the world. To combat this problem, many antihypertensive drugs have been developed and proven effective at controlling blood pressure in the last half century. In recent decades, antihypertensive drugs have been shown to have cardiovascular benefits beyond the reduction of blood pressure, and the focus has shifted to clarification of these effects. Angiotensin II receptor antagonists and calcium channel blockers are the most widely used antihypertensive drugs in Japan. However, these two classes of drugs have not yet been compared with respect to their efficacy for treating cardiovascular events.

Comparison: Response-dependent dose titration and blinded assessment of endpoints in high risk hypertensive patients treated with either an angiotensin II receptor antagonist (candesartan cilexetil) compared to a third-generation calcium channel blocker (amlodipine besilate).


Ages Eligible for Study:   25 Years to 85 Years   (Adult, Senior)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No

Inclusion Criteria:

  • Systolic blood pressure (SBP) ≥140 mmHg in those <70 years old or ≥160 mmHg in those ≥70 years old or diastolic blood pressure (DBP) ≥90 mmHg in a sitting position on two consecutive measurements at clinic
  • At least one of the following risk factors:

    • SBP ≥180 mmHg or DBP ≥110 mmHg on two consecutive visits;
    • Type 2 diabetes (fasting blood glucose ≥126 mg/dl, causal blood glucose ≥200 mg/dl, HbA1c ≥6.5%, 2 hours blood glucose on 75 g oral glucose tolerance test [OGTT] ≥200 mg/dl, or current treatment with hypoglycemic agent);
    • History of cerebral hemorrhage, cerebral infarction, or transient ischemic attack until 6 months prior to the screening;
    • Thickness of the posterior wall of left ventricle or thickness of the wall of interventricular septum ≥12 mm on echocardiography or Sv1+Rv5 ≥35 mm on electrocardiography, angina pectoris, and a past history (≥6 months before giving informed consent) of myocardial infarction;
    • Proteinuria ≥+1 or renal impairment (serum creatinine ≥1.3 mg/dl) within 3 months at the time of giving informed consent;
    • Arteriosclerotic peripheral arterial obstruction (Fontaine class ≥2); *Clinical diagnosis of Alzheimer's disease.

Exclusion Criteria:

  • SBP ≥200 mmHg or DBP ≥120 mmHg in a sitting position
  • Type I diabetes mellitus
  • History of myocardial infarction or cerebrovascular accidents within 6 months prior to the screening
  • Percutaneous transluminal coronary angioplasty (PTCA) or coronary artery bypass grafting (CABG) done within 6 months of screening or scheduled
  • Current treatment for congestive cardiac failure (New York Heart Association [NYHA] functional class II or severer) or ejection fraction <40%
  • Coronary artery disease requiring αβ blocker or calcium channel blocker
  • Atrial fibrillation or atrial flutter
  • Renal dysfunction (serum creatinine ≥3 mg/dl)
  • Hepatic dysfunction (AST and/or ALT ≥100 IU/l)
  • A history of malignant tumor within 5 years of enrollment or suspected
  • Contraindication for candesartan cilexetil or amlodipine besilate
  • Pregnancy, possible pregnancy, or plan to conceive a child within 5 years of enrollment
  • Not suited to the clinical trial as judged by a collaborating physician
  • Inability to give informed consent
  Contacts and Locations
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Please refer to this study by its identifier: NCT00125463

Kyoto University
Kyoto, Yoshidakonoe-cho, Sakyo-ku, Kyoto, Japan, 606-8501
Sponsors and Collaborators
The Japanese Society of Hypertension
Principal Investigator: Takao Saruta, M.D. Keio University
  More Information

Publications automatically indexed to this study by Identifier (NCT Number): Identifier: NCT00125463     History of Changes
Other Study ID Numbers: JSH-00001
Study First Received: July 29, 2005
Last Updated: August 8, 2005

Keywords provided by The Japanese Society of Hypertension:
clinical trial
Candesartan Antihypertensive Survival Evaluation in Japan trial
candesartan cilexetil
amlodipine besilate

Additional relevant MeSH terms:
Cardiovascular Diseases
Vascular Diseases
Candesartan cilexetil
Antihypertensive Agents
Angiotensin II Type 1 Receptor Blockers
Angiotensin Receptor Antagonists
Molecular Mechanisms of Pharmacological Action processed this record on September 21, 2017