Here is the design of a clinical trial:

Official Title: Identifying Most Effective Treatment Strategies to Control Arterial Hypertension in Sub-Saharan Africa - A Randomized Controlled Trial

Included conditions:
- Arterial Hypertension

Study Armgroups:
- {'label': 'Intervention 1: dual combination', 'type': 'ACTIVE_COMPARATOR', 'description': 'dual combination of half-dose Calcium Channel Blocker (CCB) and Angiotensin II Receptor Blocker (ARB), dosage increases at 4 and 8 weeks if target blood pressure is not reached at the respective time point', 'interventionNames': ['Other: dual combination']}
- {'label': 'Intervention 2: triple combination', 'type': 'ACTIVE_COMPARATOR', 'description': 'triple combination of quarter-dose of Calcium Channel Blocker (CCB), Thiazide diuretic (TZD) and Angiotensin II Receptor Blocker (ARB) with dosage increases of all drugs at 4 and 8 weeks, if target blood pressure is not reached at the respective time point', 'interventionNames': ['Other: triple combination']}
- {'label': 'Standard of care', 'type': 'PLACEBO_COMPARATOR', 'description': 'start normal dose Calcium Channel Blocker (CCB), add Thiazide diuretic (TZD) after 4weeks and increase of TZD dosage after 8 weeks, if target blood pressure is not reached at the respective time point', 'interventionNames': ['Other: Standard of care']}

Interventions:
- {'type': 'OTHER', 'name': 'dual combination', 'description': 'Participants will be started on a dual therapy with half dose of CCB and an ARB. If needed, a) the dose of the CCB will be increased at 4 weeks, and b) the dose of the ARB at 8 weeks, if blood pressure remains uncontrolled ((if target blood pressure is not achieved at this time point (target blood pressure defined as clinic BP \\</=130/80mmHg in patients \\<65years and \\</=140/90mmHg in patients \\>65years)', 'armGroupLabels': ['Intervention 1: dual combination']}
- {'type': 'OTHER', 'name': 'triple combination', 'description': 'Participants will be started with low dose (1/4) triple combination treatment with CCB, TZD and ARB. If uncontrolled after 4 weeks, dosages of all drugs will be doubled. If after 8 weeks still uncontrolled dosage will be increased to full dose of all three drugs ((if target blood pressure is not achieved at this time point (target blood pressure defined as clinic BP \\</=130/80mmHg in patients \\<65years and \\</=140/90mmHg in patients \\>65years)', 'armGroupLabels': ['Intervention 2: triple combination']}
- {'type': 'OTHER', 'name': 'Standard of care', 'description': 'Participants will be started on regular dose of CCB with a) addition of TZD at 4 weeks, if needed, b) increase of dose of TZD after 8 weeks, if needed (if target blood pressure is not achieved at this time point (target blood pressure defined as clinic BP \\</=130/80mmHg in patients \\<65years and \\</=140/90mmHg in patients \\>65years)', 'armGroupLabels': ['Standard of care']}

Primary Outcomes:
- {'measure': 'Proportion of patients reaching a target blood pressure', 'description': 'Proportion of patients reaching a target blood pressure (clinic blood pressure) of \\</=130/80 mmHg in patients \\<65years of age and \\</=140/90 mmHg in patients \\>65years of age', 'timeFrame': 'at 12 weeks after enrolment'}

Please estimate the sample size based on the assumption: 
Two-sided alpha of 0.05 for the superiority comparison, one-sided alpha of 0.025 for the non-inferiority comparison, power of 85% for the non-inferiority comparison, power of 95% for the superiority comparison, and a 15% dropout rate.
Sample size calculation
          We hypothesize that the proportion of participants reaching the primary endpoint will be higher in the triple combination arm compared to the control arm. Additionally, we hypothesize that the dual combination arm will be non-inferior to the control arm (TableÂ 3). We assumed a response rate in the control arm of 40%, an improvement in the triple combination arm of 15 percentage points (two-sided alpha of 0.05) for the superiority comparison between the triple combination and control arms, and a non-inferiority margin of 10% (one-sided alpha of 0.025) for the non-inferiority comparison between the dual combination and control arms. Based on these assumptions, we calculated a sample size of 431 participants in each of the control and dual combination arms, and 216 participants in the triple combination arm (power of 85% for the non-inferiority comparison and 95% for the superiority comparison). The overall sample size is therefore 1078 participants, with the randomization ratio of 2:1:2 for the dual combination, triple combination, and control arms, respectively. Assuming 15% of participants will become lost-to-follow-up [29] brings the total required sample size to 1268 individuals.
Table 3Assumptions for sample size calculationDual combination Guideline + incremental value of ARB in African patientsTriple combination quarter dose for 3 widely available drugs usedControlWHO standard of care starting with monotherapyLiteratureReported response in 67% of Africans (responseâ=âdiastolic blood pressureâ<â90âmmHg or 10% decrease [10, 52])Reported response in 83% of patients* (responseâ=âblood pressureâ<â135/85âmmHg [17])Reported response in 67% of patients in Nigeria (responseâ=âblood pressureâ<â149/90âmmHg [53])Conservative effect estimation for higher target BPÂ£60%75%50%Conservative effect estimation for lower target BP$40%55%40%Comparison with cited studiesAssumption of a smaller effect due to lower BP targetEffect might be lower (3 drugs instead of 4; no single pill)Effect might be higher as allowance to increase dosageEffect might be lower due to lower targetARB angiotensin receptor blocker, BP blood pressure, WHO World Health OrganizationÂ£140/90âmmHg$130/80âmmHg