Low-Renin Hypertension Clinical Trial
Official title:
Double Blind Crossover Comparison od Diuretics in Young Patients With Low Renin Hypertension
The principle objective of the study is to determine whether low-renin (i.e. salt sensitive)
hypertension at a young age is caused by the kidneys hanging onto too much salt as a result
of an over active salt pump in the kidney.
The kidneys have four different salt pumps, and each is blocked by a different type of
diuretic (salt losing tablet)If one out of the four is overactive, we would expect patients
to respond much better to one diuretic than to the alternatives - rather than responding
equally well to all available types of diuretic.
Studies suggest that patients with low renin hypertension respond better to diuretics than
other hypertensive drug groups. The aim of the study is to rotate patients through the four
main diuretic groups and see if it is possible to identify the most effective diuretic for
this group, as measured by a >=10mgHg decrease in Systolic blood pressure in one specific
group a compared to the others.
As most caucasians with Low renin hypertension are older (>55), presentation with this type
of hypertension at a younger age suggests the presence of substantial genetic variation in
order to cause the atypical presentation. It is hoped that by identifying the best diuretic
for these patients we will also be able to identify:
1. Whether the young low-renin hypertensives can be sub-classified according to their most
effective diuretic;
2. Whether this sub-classification helps us to identify the genes and mutations
responsible, since these are to expected to be in the so-called sodium channels (i.e.
salt pumps)which the kidneys use to prevent salt being excreted in the urine.
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Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Crossover Assignment, Masking: Double-Blind, Primary Purpose: Treatment