Active clinical trials for "Hypertension"

Study hypothesis is that the time from randomization to the increase of natriuresis (%), time to standardization of natriuresis daily profile, blood pressure profile and the percentage reduction of central hemodynamic parameters will be relatively changed over the study period by more than 15%.

This study will be used to train an algorithm using Methacetin breath test (MBT) measures and to select a cut-off to determine presence or absence of Clinically Significant Portal Hypertension (CSPH) as defined by Hepatic Venous Gradient Pressure (HVPG) ≥ 10mmHg,

The proposed research study is a cross-sectional study enrolling young children with sickle cell disease between 5 and 12 years of age. They will be screened as outpatients for consent to perform pulmonary function testing (PFT) and echocardiography. In addition, the degree of bronchodilator response will be assessed at each session. To estimate presence of pulmonary hypertension, echocardiography will be performed at the time of PFT measures. Study Design: Enroll children aged 5 to 12 years of age with sickle cell disease (HbSS, HbSC, HbS beta plus thalassemia, HbS beta zero thalassemia, and HbS OArab) who are established patients within the Duke Pediatric Sickle Cell Clinic. Perform a chart review of all enrolled subjects to obtain specific details regarding birth history, nutritional status (weight, height), family history, sickle cell genotype, parental smoking history, recent laboratory parameters, parental smoking history, any concurrent conditions (atopy, asthma, airway anomaly), history of sickle cell complications and prescribed medications. Perform spirometry and plethysmography with the administration of albuterol. Before or after completion the PFT session, the patient will have echocardiography in the PFT lab area Using medical record information, determine number of hospitalizations for any pulmonary symptoms indicative of acute chest syndrome (ACS) (dyspnea, fever, wheezing, hypoxia, cough, chest pain). In addition, we will track any respiratory or cardiac symptoms or therapies for each subject 6 years after enrollment up to age 18 years using the registry. As standard of care, refer any child identified as having lung disease or pulmonary hypertension to a pediatric pulmonologist and/or cardiologist for monitoring, treatment and ongoing care.

To reduce portal pressure, the only recommended medication is nonselective beta blocker(NSBB). However, NSBB has some limitation to apply clinically because of poor response rate and compliance. Recent literature has supported the role of bacterial translocation as a mediator of splanchnic vasodilatation and portal hypertension. This stimulates the release of pro-inflammatory cytokines and the activation of the vasodilator NO resulting in a more pronounced deterioration of the baseline hyperdynamic circulatory state. Selective gut decontamination with Rifaximin can induce inhibition of bacterial translocation and associated worsening of portal hypertension. The investigators hypothesized that Rifaximin plus NSBB could result in decrease of portal pressure in cirrhotic patients with esophageal varices.

The primary aim of the study is to design a group-based, culturally appropriate self-management skills training intervention for disadvantaged African-Americans with both diabetes and hypertension and to compile an intervention Manual of Operations (MOO). The investigators are developing an intervention to assist individuals in reducing weight and hemoglobin A1c.

The purpose of this study is to compare improvement percentage of urinary albumin excretion between valsartan 80 mg- and valsartan 160 mg-based therapy in patient with morning hypertension.

The aim of the study is to value, in patients with chronic kidney disease and hypertension, whether medical therapy plus interventional renal artery revascularization is superior to medical therapy alone for the treatment of hemodynamically significant (>70%) atherosclerotic renal artery stenosis, diagnosed by duplex doppler ultrasonography and confirmed by magnetic resonance angiography, in terms of avoidance of the progression of renal damage, control of hypertension and in reducing the cerebro and cardiovascular complications.

Hypertension is a worldwide public health challenge due to its high prevalence and along with increased risk of complications of other diseases that are more dangerous if not managed properly. An estimated 1.4 billion people worldwide have high blood pressure, but only 14% can control it. Knowledge of hypertension in patients with hypertension can prevent complications through hypertension treatment. Increasing knowledge can be done by providing education in the form of counseling by pharmacists to hypertensive patients. Counseling activities carried out by pharmacists can be supported by a technological approach. One of the uses in smartphone technology is by creating an android-based mobile application that can be developed to support pharmaceutical care. Education conducted by pharmacists can increase knowledge that will affect hypertension treatment adherence, and this education can also improve blood pressure control so that it can improve the quality of life. The purpose of this study is to analyze the influence of the android application as a standard pharmacist education tool on knowledge as well as adherence and therapeutic outcomes of hypertensive patients, and quality of life related to the health of hypertensive patients compared to just providing standard education by pharmacists to hypertensive patients at the Primary Health Care. The method used in this study is a Quasi-Experimental with Pretest - Posttest Control Group Design. Samples were obtained by purposive sampling method at the selected Primary Health Care as the intervention group and the selected Primary Health Care as the control group. Pharmacist provides education to intervention groups with android applications as counseling aids and in control groups only standard counseling is provided. Pre-test data collection was done by taking primary and secondary data of patients at the first meeting and post-test data collection was taken prospectively through face-to-face interviews and questionnaires on hypertensive patients participants for three months by observing the influence of android applications as counseling aids on knowledge of hypertensive diseases, adherence to antihypertensive treatment, outcome therapy and quality of life.

A community intervention in elderly hypertension patients by Community Health Workers in order to improve patients adherence to treatment

This is a prospective, single centre clinical investigation looking at short (6 months) and long term (24 months) changes in cardiac function and renal function in patients with drug-resistant hypertension post renal sympathetic denervation.