Hypertension Clinical Trial
To determine the role of insulin resistance in peripheral vascular dynamics, sodium sensitivity, and blood pressure regulation in a young representative Black population and in a group of young Blacks at high risk for hypertension.
BACKGROUND:
Epidemiologic studies have demonstrated a greater prevalence of essential hypertension in
Blacks with a disproportionately greater hypertension related mortality in Blacks. Similar
vascular consequences occur with diabetes and obesity. These three diseases not only share a
common outcome, but also overlap in occurrence with Blacks having greater prevalence rates
in the three disorders. Insulin resistance has been documented in all three disorders and
may contribute significantly to the vascular disease.
This project originated in response to a Request for Applications on Biobehavioral Factors
Affecting Hypertension in Blacks issued in December 1982. The original project was supported
by the RFA for three years. The first three years of the study focussed on the hypothesis
that sodium loading would augment cardiovascular responses of psychogenic stress in Blacks
at high risk for hypertension. The first phase of the study examined and compared 80 Blacks
and whites, 18-22 years of age. The second phase involved an additional 40 Black borderline
hypertensives who were exposed to the same set of studies designed to examine possible
interactions between neurogenic and renal controlled volume mechanisms in essential
hypertension.
The project was renewed as a regular research grant in 1986 and was designed to investigated
biobehavioral factors in blood pressure control. In 1988, the study on insulin resistance
was funded and continued through 1990.
DESIGN NARRATIVE:
Subjects in this project consisted of Blacks who were enrolled in the Collaborative
Perinatal Project (CPP) at birth and who had been studied longitudinally in adolescence and
young adulthood. Each subject brought to the study data on blood pressure, growth, and
maturation from birth through late adolescence.
Peripheral vascular structure was studied using measures of forearm blood flow and forearm
vascular resistance. Measurements of peripheral vascular structure were compared to data on
sodium sensitivity and potassium sensitivity in the population. Insulin resistance was
studied using the euglycemic hyperinsulinemic clamp technique. Variations in the activity of
the sodium-potassium pump and sodium-hydrogen exchange in red cells were correlated with
insulin resistance to determine if hyperinsulinemia alters cation transport rates.
The study completion date listed in this record was obtained from the "End Date" entered in
the Protocol Registration and Results System (PRS) record.
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