Dapagliflozin on Blood Pressure Variability and Ambulatory Arterial Stiffness Index in Hypertension

Hypertension Clinical Trial

Official title:

Effect of Dapagliflozin on the Blood Pressure Variability and the Ambulatory Arterial Stiffness Index in Individuals With Stage I Hypertension Without Diabetes Mellitus

Clinical Trial Details — Status: Recruiting

Administrative data

• NCT number: NCT03592667
• Other study ID #: DAPA on VBP-AASI Hypertension
• Status: Recruiting
• Phase: Phase 4
• Start date: February 14, 2019
• Est. completion date: July 2021

Study information

• Verified date: August 2020
• Source: University of Guadalajara
• Contact: MANUEL GONZALEZ, PhD
• Phone: +52-10-58-52-00
• Email: uiec[@]prodigy.net.mx
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

The prevalence of arterial hypertension has remained the same in the last 5 years, however, almost 50% of the population continues without an adequate adjustment according to the National Health Survey of the Midway 2016. It has been shown that the variability of blood pressure (VBP) during 24 h and visit-visit is associated with cardiovascular diseases (CVD) over the effect of blood pressure (BP) itself. On the other hand, arterial stiffness is well known as an independent factor of CVD risk and for its evaluation the ambulatory arterial stiffness index (AASI) has been proposed. AASI and the VPA obtained through an evaluation by ambulatory BP monitoring (ABPM) individual of 24 h. Dapagliflozin is an inhibitor of the sodium-glucose cotransporter type 2 (iSGLT2) for the treatment of diabetes mellitus type 2 (DM2) that promotes natriuresis and osmotic diuresis, which produces a decrease in plasma volume and a decrease in BP. The aim of ths study is to evaluate the effect of dapagliflozin on VBP and AASI in individuals with stage I hypertension whitout DM2. The investigators hypothesis is that the administration of dapagliflozin decreases the VBP and AASI in individuals with stage I hypertension whitout DM2.

Description:

A randomized, double-blind, placebo-controlled clinical trial in 20 patients with a diagnosis of stage I hypertension without DM2. They will be assigned randomly two groups of 10 patients each to receive 10 mg of Dapagliflozin (Forxiga, Astra Zeneca) or placebo, one per day before breakfast during 12 weeks. There will be calculated indices of VBP: 24 h, daytime and night-time standard deviation (SD), coefficient of variation (CV), 24 h weighted SD, Day-to-nigth BP changes and average real variability (AVR). On the other hand, AASI will be calculated with a linear regression. This protocol it's already approved by the local ethics committee and written informed consent it's going to be obtained from all volunteers. Statistical analysis will be presented through measures of central tendency and dispersion, average and deviation standard for quantitative variables; frequencies and percentages for variable qualitative. Qualitative variables will be analyzed by X2 o exact fisher test, will be used for differences inter-group. Mann-Whitney U Test and Wilcoxon Test for the within-groups differences. It will be considered statistical significance p ≤0.05.

Recruitment information / eligibility

• Status: Recruiting
• Enrollment: 20
• Est. completion date: July 2021
• Est. primary completion date: April 2021
• Accepts healthy volunteers: No
• Gender: All
• Age group: 30 Years to 60 Years

Eligibility

Inclusion Criteria:

• Informed consent signed
• Patients both sexes, age between 30 and 60 years
• Diagnosis of stage I hypertension according ACC/AHA (American college of cardiology/American heart association) blood pressure between 130-139/ 80-89 mmHg.
• Fasting plasma glucose < 100 mg/dl
• BMI >35 kg/m2
• Glomerular filtration rate > 60ml/min/1.73m2

Exclusion Criteria:

• Women with confirmed or suspected pregnancy
• Women under lactation and/or puerperium
• Hypersensibility to ingredients of intervention
• Physical impossibility for taking pills
• Known uncontrolled renal, hepatic, heart, thyroid or cardiovascular diseased
• Previous treatment for hypertension or depression
• Triglycerides = 400 mg/dl
• Total cholesterol = 240 mg/dl
• Worker per shift night
• Arrhythmia

Related Conditions & MeSH terms

• Hypertension

Intervention

Drug:
• Dapagliflozin
10 mg, one per day before breakfast during 12 weeks.
• Placebo - Cap
One per day before breakfast during 12 weeks.

Locations

Country	Name	City	State
Mexico	Instituto de Terapeútica Experimental y Clínica. Centro Universitario de Ciencias de la Salud. Universidad de Guadalajara	Guadalajara	Jalisco

Sponsors (1)

Lead Sponsor	Collaborator
University of Guadalajara

Country where clinical trial is conducted

Mexico, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Indices of blood pressure: 24 h, daytime and night-time SD and CV, 24 h weighted SD, day-to-nigth BP changes and ARV	Blood pressure variability will be evaluated with ambulatory blood pressure monitoring	Baseline to Week 12
Primary	Ambulatory arterial stiffness index	Arterial stiffness will be evaluated with ambulatory blood pressure monitoring	Baseline to Week 12
Secondary	Pulse Pressure of 24 h	Will be evaluated with ambulatory blood pressure monitoring, systolic BP minus diastolic BP.	Baseline to Week 12
Secondary	Mean arterial pressure of 24 h, daytime and nigth-time	Will be evaluated with ambulatory blood pressure monitoring, systolic BP minus diastolic BP/3, plus diastolic BP.	Baseline to Week 12
Secondary	Heart rate of 24 h, daytime and nigth-time	Will be evaluated with ambulatory blood pressure monitoring.	Baseline to Week 12
Secondary	Hypertensive load daytime and nigth-time	Will be evaluated with ambulatory blood pressure monitoring.	Baseline to Week 12
Secondary	White coat hypertension	will be evaluated with ambulatory blood pressure monitoring	Baseline to Week 12
Secondary	Fasting glucose levels	The fasting glucose levels will be evaluated at baseline and week 12 with enzymatic/colorimetric techniques and the entered values reflect the fasting glucose level at week 12.	Baseline to Week 12
Secondary	Total cholesterol	Total cholesterol levels will be evaluated at baseline and week 12 by enzymatic/colorimetric techniques and the entered values reflect the total cholesterol level at week 12	Baseline to Week 12
Secondary	Triglycerides levels	Triglycerides levels will be evaluated at baseline and week 12 with enzymatic/colorimetric techniques and the entered values reflect the triglycerides level at week 12	Baseline to Week 12
Secondary	High density lipoprotein (c-HDL) levels	c-HDL levels will be evaluated at baseline and week 12 with enzymatic/colorimetric techniques and the entered values reflect the c-HDL level at week 12	Baseline to Week 12
Secondary	Creatinine levels	Creatinine levels will be evaluated at baseline and week 12 with enzymatic/colorimetric techniques	Baseline to Week 12
Secondary	Uric acid levels	Uric acid levels will be evaluated at baseline and week 12 with enzymatic/colorimetric techniques	Baseline to Week 12
Secondary	Body Weight	The body weight will be measured at baseline, week 4, week 8 and week 12 with a bioimpedance balance and the entered values reflect the body weight at week 12	Baseline, week 4, week 8 and week 12
Secondary	Body Mass Index	Body Mas Index will be calculated at baseline, week 4, week 8 and week 12 with the Quetelet index formula and the entered values reflect the body mass index at week 12	Baseline, week 4, week 8 and week 12
Secondary	Waist circumference	Waist circumference will be evaluated with the method proposed by ISAK.	Baseline, week 4, week 8 and week 12
Secondary	Glomerular filtration rate	Glomerular filtration rate will be calculated at baseline and week 12 with the Cockcroft-Gault formula and the entered values reflect the Glomerular filtration rate at week 12	Baseline to Week 12