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NCT ID: NCT01703780 Active, not recruiting - Clinical trials for Hypertension, Resistant to Conventional Therapy

The Diagnosis and Treatment of Resistant Hypertension, the Prevalence and the Prognosis

doublepres
Start date: July 2012
Phase: N/A
Study type: Observational

Hypertension is still one of the major preventable risk factor for cardiovascular as well as cerebrovascular diseases globally, including ischaemic heart disease, heart failure, and renal impairment. Despite knowledge on hypertension and the availability of effective antihypertensive medications have progressed dramatically in recent years, the rate of uncontrolled hypertension ( reached 90%) remains high in China[1]. Among those with uncontrolled hypertension,it has been reported that 8.9% in all individuals with hypertension, and 12.8% in the hypertensive drug-treated population[2] are attributed to resistant hypertension. Resistant hypertension has been defined by AHA as high blood pressure (BP) in spite of appropriate lifestyle interventions and treatment of three or more different types of antihypertensive drugs at optimal dose, including at least one diuretics[3,4] or achieving adequate BP control with optimal doses of 4 or more antihypertensive drugs. At present, not many specifically designed prospective researches concerning resistant hypertension are available. The prevalence of resistant hypertension is not well established and most knowledge about resistant hypertension derives from cross-sectional analyses and clinical trials. The patients with resistant hypertension have been expected to have server target damage, and worse prognosis than those who are non-resistant, but not well established either in the literature[2]. The purpose of this study is to determine the prevalence of resistant hypertension ascertained with systemic investigation and optimal treatment with antihypertensive drugs in community populations and clinic as well as the prognosis among patients with resistant hypertension compared with those who are non-resistant.

NCT ID: NCT01674686 Recruiting - Variant Angina Clinical Trials

The Effect of Sarpogrelate and High Dose Statin on the Reduction of Coronary Spasm

Start date: August 1, 2012
Phase: Phase 4
Study type: Interventional

The aim of the study was to to evaluate the effect of sarpogrelate, a selective serotonin receptor antagonist, and high dose statin on the reduction of coronary spasm in the patients with variant angina.

NCT ID: NCT01673516 Active, not recruiting - Clinical trials for Hypertension, Resistant to Conventional Therapy

Effect of Renal Sympathetic Denervation on Resistant Hypertension and Cardiovascular Hemodynamic in Comparison to Intensive Medical Therapy Utilizing Impedance Cardiography

OsloRDN
Start date: August 2012
Phase: Phase 2
Study type: Interventional

The purpose of this study is to demonstrate that Renal Sympathetic Denervation (RDN) improves the control of blood pressure (BP) in patients with treatment-resistant hypertension, as compared to intensive medical therapy (IMT) using hemodynamic parameters and then applying a predefined algorithm of drug selection (i.e. integrated hemodynamic management - IHM) during 6 months intensive treatment program (receiving antihypertensive care according to the 2007 ESH Guidelines). Working hypothesis: When it is possible to disrupt the sympatho-renal axis by RDN - BP reduction occurs to a greater extent and more rapidly than applying intensive medical therapy using IHM.

NCT ID: NCT01630928 Completed - Clinical trials for Hypertension, Resistant to Conventional Therapy

Renal Sympathetic Denervation and Potential Effects on Glucose Metabolism and Cardiovascular Risk-Factors

Re-Shape
Start date: March 2013
Phase: N/A
Study type: Interventional

The Re-Shape CV-Risk Study is a clinical study where renal adrenergic denervation (RDN) is done in high risk patients with treatment-resistant hypertension. RDN is a mini-invasive, percutaneous technique where an ablation catheter is inserted through a femoral artery into the renal arteries, for destruction of the adrenergic nerve bundles in the artery adventitia by means of radio-frequency ablation. RDN leads to sympathetic denervation of the kidneys, which in the "Symplicity trials" led to an impressive reduction of blood pressure (- 33 /-11 mmHg). In a pilot study, where 40 % of the patients had diabetes, RDN seemed to have beneficial effects not only on blood pressure, but also on insulin sensitivity and hyperinsulinaemia. The investigators aim to introduce RDN as a clinical study where blood pressure reduction and methodical, technical aspects will be evaluated, but more importantly, also additional effects of RDN on sub-clinical organ damage (endothelial function, vascular stiffness, fundus-, heart-, kidney injury), quality of life, arrhythmia, and glucose metabolism. The investigators hypothesis is that RDN will have positive effect on glucose metabolism, QOL and sub-clinical organ damage.

NCT ID: NCT01570777 Completed - Clinical trials for Hypertension, Resistant to Conventional Therapy

Renal Denervation in Hypertension

DENER-HTN
Start date: April 2012
Phase: Phase 4
Study type: Interventional

The DENER-HTN study is a, multicenter, prospective, open, randomized, controlled study of the effectiveness and costs of renal denervation in addition to standardized medical treatment compared to medical treatment alone in subjects with resistant hypertension. Bilateral renal denervation will be performed using the Symplicity Catheter - a percutaneous system that delivers radiofrequency (RF) energy through the luminal surface of the renal artery.

NCT ID: NCT01520506 Completed - Clinical trials for Hypertension, Resistant to Conventional Therapy

Rapid Renal Sympathetic Denervation for Resistant Hypertension

RAPID
Start date: May 2012
Phase: N/A
Study type: Interventional

The Covidien OneShot™ ablation system use is to deliver low-level radio frequency (RF) energy through the wall of the renal artery to denervate the human kidney.

NCT ID: NCT01459042 Completed - Clinical trials for Hypertension, Resistant to Conventional Therapy

Prevalence of Primary Aldosteronism in Patients With Resistant Hypertension in China

Start date: January 2010
Phase: N/A
Study type: Observational

Recent studies indicate that primary aldosteronism (PA) is a much more common cause of hypertension than had been demonstrated historically. In patients with resistant hypertension, the prevalence of PA from different clinics worldwide is about 10-20%. As has been no such data in China, the investigators are conducting a PA study in different province of China to evaluate the prevalence of PA in patients with resistant hypertension.

NCT ID: NCT01317329 Completed - Obesity Clinical Trials

"Reversibility of Cardiovascular Injury With CPAP Use: Mechanisms Involved"

Start date: March 2011
Phase: N/A
Study type: Interventional

The purpose of this study is to determine the factors that are associated with improved cardiovascular function with the use of CPAP therapy on subjects diagnosed with moderate to severe obstructive sleep apnea.

NCT ID: NCT01173029 Completed - Stroke Clinical Trials

Renin-angiotensin-aldosterone System Polymorphisms in Resistant Hypertension and Adverse Cardiovascular Events

GENHART
Start date: June 2001
Phase: N/A
Study type: Observational

Renin-angiotensin-aldosterone system (RAAS) polymorphisms influence 24h arterial pressure fluctuation. Resistant systemic arterial hypertension (RSAH) has an increased risk of end organ damage and unfavourable prognosis, whereas pseudo-RSAH usually respond favourably to drug therapy. To prospectively investigate, in subjects with RSAH in a tropical South American city: 1) Adverse cardiovascular events defined as fatal and non-fatal stroke or acute myocardial infarction (AMI); and 2) the association of RAAS polymorphisms and adverse cardiovascular events in this population. Study population: 212 hypertensives recruited from primary care assistance (time since first diagnosis of hypertension: 16.5±8.1 years) and without appropriate pressure control, between 2001 and 2006, corresponding to 0.48% of all hypertensives under care (18 new cases/year), 57±10 years old, 66% females. Under drug treatment schedule: three or more drugs including a diuretic. Ninety two randomly selected hypertensives basis had renin-angiotensin-aldosterone system genetic profile determined. Genetic assessment was carried out using a polymerase chain reaction assay amplification technique. The following single nucleotide polymorphisms were analyzed: renin (G1051A), angiotensinogen (M235T), angiotensin converting enzyme-ACE (I/D), angiotensin II type 1 receptor (A1166C), aldosterone synthase (C344T) and mineralocorticoid receptor (G3514C).

NCT ID: NCT01117025 Completed - Atrial Fibrillation Clinical Trials

Combined Treatment of Resistant Hypertension and Atrial Fibrillation

Start date: April 2010
Phase: Phase 2
Study type: Interventional

The purpose of this study is the comparative evaluation of systolic blood pressure (SBP) lowering, atrial fibrillation (AF) recurrence and clinical data in patients with paroxysmal/persistent AF and resistant hypertension, undergoing AF ablation alone or combined with percutaneous renal denervation.