Active clinical trials for "Hypertension"

Social networks, social capital, i.e., network-accessed resources, and neighbourhood environments have been shown associated with a range of health behaviours and conditions, including obesity, physical activity, nutrition, and mental health. Research on social capital and health in Montreal has shown the importance of network social capital for a person's subjective health status, sense of control, self-reported physical activity, and obesity. Research has also shown high social capital to reduce health service use, mental health service use, and improve the management of chronic illnesses. Despite advances in the understanding of social capital and its link to health and health service use, most research on social capital is cross sectional and is unable to identify the causal pathways linking social networks and capital to health and health care use. Longitudinal research would strengthen the evidence base for designing interventions to prevent or delay the use of health services, particularly in older adults. This research has three main objectives: (1) transform the original sample of Montreal Neighbourhood Networks and Healthy Aging (MoNNET-HA) households (n=2707) into a panel study, (2) link the MoNNET-HA participant data to their Quebec Health Insurance Registry (Régie de l'assurance maladie (RAMQ)) information, and (3) assess the feasibility of extending the MoNNET-HA panel by one wave to include participant's core network members. Unique about the original MoNNET-HA sample is that it purposefully oversampled older adults (> 64 years old) but remains representative of Montreal adults at various ages and income levels. In addition, MoNNET-HA data is integrated into a GIS database which allows researchers to examine the effects of neighbourhood environmental characteristics on health. By linking MoNNET-HA data to RAMQ, researchers will be able to examine patterns of diagnosed health conditions, (e.g., fractures, depression), pharmaceutical use and adherence, and formal health care use over time. Transforming the cross-sectional study into a panel study would also allow researchers to examine longitudinally the dynamics of health and health care utilization among Panel participants over the life course, and the causal pathways linking neighbourhoods and networks to health and health care use.

Systemic sclerosis (SSc, AKA scleroderma) is an autoimmune condition characterized by endothelial damage and progressive fibrosis of the skin and internal organs. One of the leading causes of morbidity and mortality in patients with SSc is pulmonary hypertension (PH), which is estimated to occur in up to 31% of high risk SSc patients. Early detection of patients with SSc-PH may lead to improved outcomes and although there have been concerted efforts to accurately screen for SSc-PH, these patients continue to present with advanced disease and suffer from poor survival. Therefore, better methods to screen for patients with PH and, perhaps more importantly, to screen for those at risk for PH development are desperately needed. Since PH and SSc are disorders originating from the endothelium, biomarkers that reflect endothelial damage are very promising tools to identify early disease. Such potential biomarkers include endothelial microparticles, asymmetric dimethylarginine (ADMA), pentraxin-3, and soluble endoglin. No previous study has used a combination of these biomarkers to detect the presence of PH in patients with SSc, or studied the novel concept of exercise-induced changes in biomarker levels. The investigators will collect the above listed endothelial biomarkers before and after exercise, and combine these levels with exercise echocardiogram findings, and routine clinical information to derive a composite detection score for the early identification of systemic sclerosis-associated PH.

The prevalence of hypertension in patients with CKD in China is high but the control rate is low. Compared with the single blood pressure measurement method of the blood pressure of the office, ambulatory blood pressure monitoring (ABPM) can reflect the overall situation of 24-hour blood pressure, dynamic fluctuation degree and circadian rhythm change more completely and objectively. Studies have shown that patients with CKD with hypertension have their own uniqueness through ABPM measurement, and nocturnal hypertension is the main cause of poor blood pressure control. Further studies have shown that nocturnal hypertension is an independent and more effective prognostic indicator of death and CVD in patients with hypertension. Evidence from European and American countries suggests that in the CKD population, elevated nighttime blood pressure is more predictive of CKD progression or CVD than daytime blood pressure. Compared with countries such as Europe and the United States, there are differences in the causes, genetic background and daily behaviors of kidney disease in our population. It is urgent to investigate the predictive value of nocturnal hypertension for renal end point and CVD in CKD population in China. To this end, our study found for the first time that CKD patients generally have changes in nocturnal blood pressure patterns, and the anti-dope type blood pressure pattern is closely related to the target organ damage. Our further study found that the incidence of nocturnal hypertension in Chinese patients with CKD is more than 50%, and compared with non-dipping blood pressure, patients with nocturnal hypertension have more serious target organ damage, which is independent risk factors for all-cause death, cardiovascular death, renal events, and cardiovascular events in patients with CKD. These preliminary results suggest the role of nocturnal hypertension in the prognosis of CKD patients in China, but there are still the following questions: Is the occurrence of nocturnal hypertension in CKD patients related to certain gene expression? This project intends to perform whole-genome exon sequencing and analysis on CKD patients with nocturnal hypertension to determine the genetic mechanism of CKD patients with nocturnal hypertension. The completion of the subject will reveal the genetic characteristics of CKD patients with nocturnal hypertension, and provide a basis for the precise prevention and treatment of chronic kidney disease hypertension.

Background. Angiotensing converting enzyme type 2 (ACE2), a key enzyme of the renin-angiotensin-aldosterone system (RAAS), is the receptor of SARS-CoV-2 for cell entry into lungs. Because ACE2 may be modulated by RAAS inhibitors, such as angiotensin converting enzyme inhibitors (ACEi) and angiotensin II receptor blockers (ARBs), there is concern that patients treated with ACEi and ARBs may be at higher risk for COVID-19 infection and severity. Aim. To analyze the associations between COVID-19 and hypertension, and treatments with ACEi and ARBs. Methods. In this retrospective observational study, consecutive patients hospitalized for suspected COVID-19 pneumonia will be divided into 2 groups, whether or not COVID-19 is confirmed. The two groups will be compared for baseline characteristics, mainly prior treatment with ACEi and ARBs, and clinical outcome at 1-month follow-up. The main hypothesis is that ACEi and ARBs, which interact differently with ACE2, may have different relationships with COVID-19 infection or severity.

Frailty is a syndrome in which the accumulation of small, individually insignificant deficits leads to heightened vulnerability to adverse events and predisposes to potential catastrophic decompensation. Objective of this study is to clarify the underlying genetic and immunological mechanisms responsible of frailty condition focused on: i. nephrosclerosis ageing kidney phenotype related to salt effects on immunosystem, ii. immunological aspect of sarcopenia, iii. psychological disorder related to immunosystem activation, iv. detection of new biomarkers of frailty.

This is a prospective observational study on a cohort of patients with castration-resistant prostate cancer M0, treated with Apalutamide, at the Oncology Unit of the "Andrea Tortora" Hospital of Pagani. Data will be collected on the patient's clinical history and the treatments carried out until the start of therapy with Apalutamide. At that time the study will be described to the patient and informed consent will be given. In case of a favorable opinion from the patient, the CRF will be filled in. Patients with CRPC M0 treated with Apalutamide, belonging to the Oncology Unit of the Pagani Hospital "Andrea Tortora" and of the other Oncology Units of the ASL of Salerno (Hospital of Vallo della Lucania) will be studied with the possibility of enrollment also from other Centers outside the Salerno ASL.

Assessment of the influence of different antihypertensive drugs on serum uric acid in newly diagnosed hypertension patients.

The study is a cross-sectional study investigating the correlation between periodontitis and both hypertension and body mass index among a sample of adult Egyptian dental patients attending diagnostic center at faculty of Dentistry, Cairo University.

The purpose of this study was to investigate in large scale routine primary care data whether frailty is a prognostic factor for relevant outcomes in the management of hypertension in older people and whether frailty causes effect modification of the association of blood pressure or blood pressure lowering treatment and outcomes in older people.

Hypertension is a serious threat to human health and a major global economic burden. Chronic hypertension can cause left ventricular remodeling and loss of function, eventually leading to heart failure. Exploring the early changes and mechanisms of left ventricular cardiac function caused by hypertension, and to identify individuals who may develop into serious heart injury, may play a positive role in the early prevention and control of heart failure caused by hypertension. Therefore, this study intend to use two dimensional speckle tracking technology, a non-invasive method to measure left ventricular pressure-strain loop to quantitatively reflect cardiac work index , to study different hypertension patients with normal left ventricular ejection fraction the change of the global and local cardiac work, and the influence of aterosclerosis in the patients to myocardial work, and explore their relationship with ventricular remodeling and abnormal diastolic function. To improve the understanding of the pathophysiology of hypertension, hypertensive heart disease and heart failure, and to provide scientific support for the early prevention and control of such diseases. Myocardial work analysis Echocardiography plays a central role in the evaluation of patients with cardiovascular disease. Echocardiography is widely available and allows characterization of the functional and structural of heart. Thus, assessment of left lentricular (LV) global longitudinal strain (LVGLS) and Myocardial work indexes has proven benefit for both diagnosis and risk in hypertension patients.