Hypertension Clinical Trial
Official title:
A Randomized, Double Blind, Active Comparator, Parallel-group Study to Determine Whether the Combination of Valsartan and Aliskiren Provides Cardioprotection in African American Patients With Hypertension and Elements of the Metabolic Syndrome
Study purpose: African Americans with hypertension and markers of metabolic syndrome (small
elevations in blood glucose, triglycerides and or weight) are at a high risk of
cardiovascular (heart and blood vessel) problems. There is a circulating factor called
angiotensin II that increases risk and may be more important in African Americans who have
up to 20 times greater risk of losing kidney function and requiring dialysis. Research
Investigators, including those at the University of Michigan, found one drug (Ramipril) that
blocks angiotensin II effects significantly and improves kidney function in African
Americans.
The purpose of The SAAVE Study is to determine whether the combination of two new blockers
(Valsartan and Aliskiren) of angiotensin II, are better able to lower blood pressure, also
improve some of the risk factors for cardiovascular problems and provide greater protection
to the heart and kidneys.
The specific hypothesis of this proposal is that the combination of Valsartan/Aliskiren will
provide incremental reduction in blood pressure when compared to traditional blockade of
Renin Angiotensin Aldosterone System (RAAS) with ramipril. As an exploratory analysis, we
propose that the blood pressure effect will be associated with suppressing plasma
aldosterone levels, preserving the availability of nitric oxide, and preventing the
development of insulin resistance. Other variables of interest include changes from baseline
in adiponectin, Procollagen 1 and 3, osteopontin, cystatin C, and serum K+. In a nested
cohort we will determine the impact of novel dual RAAS blockade on left ventricular
remodeling.
Should our hypotheses be proven correct and novel dual RAAS blockade is more effective than
ramipril in reducing blood pressure, plasma aldosterone, preserving the availability of
nitric oxide, as reflected by an increase in asymmetric dimethly arginine (ADMA) levels, and
improves cardiovascular remodeling, this would have important implications for the long term
prevention of target organ damage and cardiovascular events in this high risk ethnic group.
;
Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Double Blind (Subject, Caregiver, Investigator, Outcomes Assessor), Primary Purpose: Treatment
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