Evaluation of Systemic Microvascular Reactivity in Patients With Resistant Hypertension
Study Details
Study Description
Brief Summary
Systemic arterial hypertension is a serious health problem worldwide. In some cases, it can phenotypically present as resistant arterial hypertension, which consists of blood pressure levels outside the treatment goals in patients using three or more classes of antihypertensive drugs, one of which is preferably a thiazide diuretic. Resistant hypertension contributes to a 47% higher risk of developing cardiovascular events when compared to patients with non-resistant hypertension. It is known that the microcirculation plays a relevant role in the pathophysiology of arterial hypertension. Furthermore, it is known that the cutaneous microvascular network is an adequate model and that it reflects the systemic microcirculation. In this sense, the present research proposes the study of cutaneous capillary density - through high resolution intravital microscopy - and of the endothelium-dependent and independent microvascular vasodilator response - by the speckle laser flowmetry method coupled to a pharmacological system of micro- iontophoresis - in patients diagnosed with resistant hypertension, with the aim of identifying changes in comparison with patients with non-resistant hypertension and normotensive individuals. Additionally, the evaluation of the association between systemic microvascular function and the presence of target organ lesions in this population may indicate that this is a new non-invasive way of stratifying cardiovascular risk in these individuals.
| Condition or Disease | Intervention/Treatment | Phase |
|---|---|---|
|
Study Design
Arms and Interventions
| Arm | Intervention/Treatment |
|---|---|
| Resistant hypertension Patients presenting with resistant hypertension |
Diagnostic Test: Evaluation of systemic skin microvascular endothelial function
Laser-based method for evaluating non-invasive, operator-independent systemic microvascular function that detects microvascular flow in the skin for the evaluation of systemic vascular endothelial function.
|
| non-resistant hypertension Patients presenting with non-resistant hypertension |
Diagnostic Test: Evaluation of systemic skin microvascular endothelial function
Laser-based method for evaluating non-invasive, operator-independent systemic microvascular function that detects microvascular flow in the skin for the evaluation of systemic vascular endothelial function.
|
| normotensive subjects control group including normotensive volunteers |
Diagnostic Test: Evaluation of systemic skin microvascular endothelial function
Laser-based method for evaluating non-invasive, operator-independent systemic microvascular function that detects microvascular flow in the skin for the evaluation of systemic vascular endothelial function.
|
Outcome Measures
Primary Outcome Measures
- Systemic microvascular reactivity [two years - during one visit to the microcirculation laboratory]
evaluation of endothelium-dependent and -independent microvascular function
Eligibility Criteria
Criteria
Inclusion Criteria:
- Resistant hypertension
Exclusion Criteria:
-
Pregnancy or lactation for all groups.
-
For the control group: endocrine and metabolic diseases, including diabetes mellitus, cardiovascular diseases, including hypertension, autoimmune diseases and cancer.
-
For the resistant arterial hypertension and non-resistant arterial hypertension groups: endocrine diseases, except diabetes mellitus, autoimmune diseases and cancer .
Contacts and Locations
Locations
| Site | City | State | Country | Postal Code | |
|---|---|---|---|---|---|
| 1 | Eduardo Tibiriçá | Rio de Janeiro | Brazil | 22240006 |
Sponsors and Collaborators
- National Institute of Cardiology, Laranjeiras, Brazil
Investigators
None specified.Study Documents (Full-Text)
None provided.More Information
Publications
None provided.- CAAE 53946021.8.0000.5272