Hypertension Clinical Trial
To determine whether differences in the activity of the renin-angiotensin and bradykinin systems are involved in the pathogenesis of blood pressure variation in African Americans.
BACKGROUND:
Each year, more than 40,000 new patients require treatment for end stage renal disease, a
condition which is 4-fold higher among African Americans than Caucasians. Trials of
angiotensin converting enzyme inhibitors (ACEIs) in Caucasians support a role of the
renin-angiotensin system in the pathogenesis of glomerulosclerosis. Yet, despite the high
prevalence of nephropathy among African Americans, Blacks have been under-represented in
studies in ACEIs. Data from our laboratory suggest that the renal effects of ACEI may differ
in African Americans. African Americans are resistant to the anti-hypertensive effects of
ACEI and, thus, may be resistant to the renoprotective effects as well. The ACE deletion
allele, a variant associated with increased ACE activity and progression of renal diseases,
is increased in frequency in African Americans, while the frequency of the Ang AT1 receptor
C allele, a variant associated with antihypertensive responsiveness to ACEI is decreased.
Moreover, African Americans exhibit decreased sensitivity to Ang I and increased sensitivity
to bradykinin. Taken together, these data suggest the hypothesis that ACE activity is
increased in African Americans, leading to decreased bradykinin levels ( and receptor
sensitization) and increased tissue Ang II (and receptor desensitization).
DESIGN NARRATIVE:
The study tests the hypothesis that ACE activity is increased in African Americans, leading
to decreased bradykinin levels (and receptor sensitization) and increased tissue Ang II (and
receptor desensitization). The effects of race, hypertension and ACE insertion/deletion
genotype on ACE activity will be determined, as measured by the pressor and renal
vasoconstrictor responses to Ang I and Ang II and the vasodilator response to bradykinin.
Specific bradykinin and angiotensin receptor antagonists will be used to determine the
relative contribution of increased bradykinin and decreased angiotensin II to the renal
hemodynamic effects of ACEIs in African Americans and Caucasians.
;
Observational Model: Case-Crossover
| Status | Clinical Trial | Phase | |
|---|---|---|---|
| Terminated |
NCT04591808 -
Efficacy and Safety of Atorvastatin + Perindopril Fixed-Dose Combination S05167 in Adult Patients With Arterial Hypertension and Dyslipidemia
|
Phase 3 | |
| Recruiting |
NCT04515303 -
Digital Intervention Participation in DASH
|
||
| Completed |
NCT05433233 -
Effects of Lifestyle Walking on Blood Pressure in Older Adults With Hypertension
|
N/A | |
| Completed |
NCT05491642 -
A Study in Male and Female Participants (After Menopause) With Mild to Moderate High Blood Pressure to Learn How Safe the Study Treatment BAY3283142 is, How it Affects the Body and How it Moves Into, Through and Out of the Body After Taking Single and Multiple Doses
|
Phase 1 | |
| Completed |
NCT03093532 -
A Hypertension Emergency Department Intervention Aimed at Decreasing Disparities
|
N/A | |
| Completed |
NCT04507867 -
Effect of a NSS to Reduce Complications in Patients With Covid-19 and Comorbidities in Stage III
|
N/A | |
| Completed |
NCT05529147 -
The Effects of Medication Induced Blood Pressure Reduction on Cerebral Hemodynamics in Hypertensive Frail Elderly
|
||
| Recruiting |
NCT05976230 -
Special Drug Use Surveillance of Entresto Tablets (Hypertension)
|
||
| Recruiting |
NCT06363097 -
Urinary Uromodulin, Dietary Sodium Intake and Ambulatory Blood Pressure in Patients With Chronic Kidney Disease
|
||
| Completed |
NCT06008015 -
A Study to Evaluate the Pharmacokinetics and the Safety After Administration of "BR1015" and Co-administration of "BR1015-1" and "BR1015-2" Under Fed Conditions in Healthy Volunteers
|
Phase 1 | |
| Completed |
NCT05387174 -
Nursing Intervention in Two Risk Factors of the Metabolic Syndrome and Quality of Life in the Climacteric Period
|
N/A | |
| Completed |
NCT04082585 -
Total Health Improvement Program Research Project
|
||
| Recruiting |
NCT05121337 -
Groceries for Black Residents of Boston to Stop Hypertension Among Adults Without Treated Hypertension
|
N/A | |
| Withdrawn |
NCT04922424 -
Mechanisms and Interventions to Address Cardiovascular Risk of Gender-affirming Hormone Therapy in Trans Men
|
Phase 1 | |
| Active, not recruiting |
NCT05062161 -
Sleep Duration and Blood Pressure During Sleep
|
N/A | |
| Not yet recruiting |
NCT05038774 -
Educational Intervention for Hypertension Management
|
N/A | |
| Completed |
NCT05087290 -
LOnger-term Effects of COVID-19 INfection on Blood Vessels And Blood pRessure (LOCHINVAR)
|
||
| Completed |
NCT05621694 -
Exploring Oxytocin Response to Meditative Movement
|
N/A | |
| Completed |
NCT05688917 -
Green Coffee Effect on Metabolic Syndrome
|
N/A | |
| Recruiting |
NCT05575453 -
OPTIMA-BP: Empowering PaTients in MAnaging Blood Pressure
|
N/A |