Active clinical trials for "Hypertension"

Essential hypertension is a complex trait that results from interaction between environmental factors and genetic factors. Salt sensitivity is the genetic susceptibility of blood pressure to salt, and it is an intermediate genetic phenotype of essential hypertension. This study aims to investigate the effects of interaction between salt sensitivity genomics and environmental factors on long-term blood pressure (BP) and target organ damage based on two established cohorts including "the cohort of Hanzhong adolescent hypertension study" and "the cohort of Mei county adult salt-sensitive hypertension study". Firstly, the Hanzhong cohort-based follow-up study is designed to observe the track of BP from childhood, and to explore the effects of many risk factors (such as salt-sensitivity, obesity et al) on long-term BP changes and the occurrence of TODs. In addition, by using DNA samples collected from subjects of "Mei county adult salt-sensitive hypertension study" in which all participants had completed a chronic salt loading and potassium intervention trial, investigators attempt to carry out whole-exome sequencing (WES), whole-genome DNA methylation and transcriptome detection, and analyze the relationship between salt sensitivity genomics and BP responses to dietary sodium/potassium intervention, long-term BP change, the risk of target organ damages. Investigators aim to explore the role of risk factors, including salt sensitivity, in the development of hypertension, and to illustrate the effects of interaction between salt sensitivity genomics and environmental factors on hypertension and target organ damage. This study would enable the investigators to further explore the genetic mechanism of essential hypertension, to identify new genetic markers for predicting early hypertension and target organ damage as well as to provide the basis for the prevention, targeted treatment, and new drugs development of hypertension in the future.

The aim of the study is to determine whether selenoprotein activity and blood renalase level correlate with subclinical hypertensive heart disease and obstructive sleep apnea. The correlation will be assessed using selected electrocardiographic, ultrasound and laboratory indicators.

Hospitalized patients with COVID-19 will be included in the study in centers around Poland. After the hospitalization, a short questionnaire will be completed, including pre-hospitalization diagnoses, pre-hospitalization medications, clinical status on admission, the course, complication and the duration of hospitalization. The questionnaire will be available in paper form and on-line.

To evaluate the safety and effectiveness of a fixed-dose combination containing valsartan and rosuvastatin (Rovatitan® Tablet) in patient with hypertension and hypercholesterolemia

A retrospective analysis

In recent years, with the investment from government in the health management of the elderly, community management of hypertension in the elderly has made great progress in management rate and standardized management, but the management of young and middle-aged patients with hypertension is still blank. Workplace pressure measurement may be more suitable for most of the young and middle-aged patients to find high blood pressure and monitor blood pressure changes in time. However, there is not much research on workplace pressure measurement. Whether blood pressure measurement in the workplace can reduce the white coat effect, and how it relates to home blood pressure and ambulatory blood pressure is still unclear.

Finding early predictors of myocardial in patients with hypertension Scientific objective The study objective is to clarify the grounds of heart exertional dyspnoea stenocardial pain in patients with well-controlled stage I or II hypertension according to ESH (European Society of Hypertension), without changes in epicardial coronary arteries in coronary angiography and normal resting echocardiography result, and to assess of potential early markers of heart hypertrophy and failure in patients with hypertension. Characteristics of the final result The study is to allow for identification of patients with hypertension, in whom an early introduction of pharmacological treatment of heart failure should be considered. Evaluation in the detection of asymptomatic myocardial dysfunction will include potential heart failure markers such as: cardiotrophin 1, cystatin C, serum syndecan-4, collagen III N-terminal propetide [PIIINP], MMP-2, MMP-7, MMP-8, MMP-9 and NT-proBNP, modern echocardiography methods and magnetic resonance imaging in order to increase the effectiveness of prevention, diagnosis and treatment optimalization. Project significance Prognosis in heart failure is very serious. It is similar or worse than in advanced cancer. These data indicate an extreme importance of the optimal early causal treatment of hypertension and symptomatic treatment of heart failure early stage in order to prevent the development advanced form of the disease, which has bad prognosis. In clinical practice, patients with well-controlled hypertension often report exercise limitation, exertional dyspnea and/or stenocardial pain which is not reflected in a standard resting echocardiography (normal result), without coronary artery disease data in electrocardiographic stress test and without change in epicardial coronary vessels in coronary angiography. The study is designed to establish the panel of diagnostic tests in patients with hypertension and exertional dyspnoea only, which will allow for early detection of abnormalities (before symptoms occur) and the start of the optimal treatment for these patients. Unfortunately, still too small percentage of patients receives full pharmacotherapy, hence the authors of the latest guidelines of procedure in heart failure and hypertension put great emphasis on this aspect. Optimal management may prevent the progression of these patients in stage C heart failure, and thus bring tangible benefits not only the patients themselves but also, by reducing the number of costly hospitalizations, significantly reduce health care costs. The number of hospitalizations for heart failure in Poland is estimated at 100 000 per year, and hospitalization costs exceed 70% of the total costs associated with the treatment of heart failure. The issue of exertional dyspnoea and overt heart failure in patients with hypertension and normal results of resting echocardiography is a new problem, both in Poland and in the world. So far, there are no treatment recommendations for this group of patients. Material and study plan 120 persons (age 40-60 years old) will be included in the study, patients with stage I or II primary hypertension according to the European Society of Hypertension: Group A- 40 patients without symptoms of heart failure Group B- 40 patients with exertional dyspnoea Group C - 40 patients with overt heart failure In group B (patients with exertional dyspnea/stenocardia) we will include only patients who have undergone contrast coronary angiography without any identified changes in the epicardial coronary arteries, which will facilitate answering the presented purpose of research. Patients in groups A and B with normal resting echocardiography and treated with a maximum of 2 antihypertensive drugs (an ACE inhibitor or a sartan as therapy base), according to the following regimen: ACEI/ARB + diuretic ACEI/ARB + calcium channel antagonist Group C - treatment in accordance with the standards for heart failure. Each patient will be informed about the objectives of the study and give written consent to participate. After signing informed consent patients will have performed the following tests: Interview and documentation analysis, Physical examination, Electrocardiogram, 24-hour blood pressure monitoring (ABPM), 24-hour EKG recording, Echocardiography at rest and during submaxinal exercise on a bicycle ergometer, Flow-mediated dilatation (FMD), Cardiac magnetic resonance imaging, Standard labolatory parameters, Levels of markers: cystatin C, cardiotrophin-1, metaloproteinases: MMP-2, MMP-7, MMP-8, MMP-9, Procollagen III N-Terminal Propeptide (PIIINP), Syndecan 4 (SDC4) and NT-proBNP Each patient will be informed about the objectives of the study and give written consent to participate.

Electrical stimulation of carotid baroreceptors (baropacing) acutely decreases arterial pressure in patients with refractory hypertension. The reduction in blood pressure seems to be mediated through sympathetic inhibition with concomitant reduction in the activity of the renin-angiotensin system. Indeed, switching on and off the stimulation is accompanied by decreases and increases in central sympathetic vasoconstrictor outflow, respectively. Plasma renin concentration also decreases with acute electrical baroreflex stimulation. In some patients chronic baropacing is associated with long-term blood pressure reduction. However, there is sparse information as to the relative contribution of blood pressure regulating systems to account for the acute and chronic effects of baropacing. Sympathetic, renal, and vascular mechanisms are of special interest. Furthermore, technical aspects of electrical baroreflex stimulation may play a role, e.g. worsening of the electrical contact between the stimulating electrodes and the baroreceptor afferents. This study is designed to answer the following primary questions: Does chronic electrical stimulation of carotid baroreceptors inhibit sympathetic vasoconstrictor tone also in the long-term? Does sympathetic vasoconstrictor tone increase on switching off chronic baropacing? Such an increase would confirm electrical integrity of the system and proper contact to the baroreceptor afferents. Does acute electrical baroreflex stimulation decrease renal vascular resistance? Does acute electrical baroreflex stimulation influence glucose delivery to skeletal muscle and change insulin sensitivity? The study follows an open-label observational design and it is planned to recruit up to 30 patients over 3 years.

Retrospective analysis of efficacy of selective laser trabeculoplasty in patients under treatment with topical prostaglandins compared to patients without topical prostaglandins is performed. Inclusion criterion are patients with glaucoma or ocular hypertension, who underwent treatment with selective laser trabeculoplasty due to insufficient control of intraocular pressure during their routine treatment at the University Hospital Zurich / Division of Ophthalmology.

The purpose of this study is to determine if a reduction in systolic blood pressure induced by anti-hypertensive medication results in changes in cerebral perfusion and cognition in hypertensive elderly. Hypertensive elderly will be treated using open-label anti-hypertensive medication for 8-12 weeks. Changes in cerebral perfusion and cognition will be assessed before and after treatment.