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Source: isrctn - Le promoteur: Second Hospital of Hebei Medical University (China)
Second Hospital of Hebei Medical University (China) MAJ Il y a 4 ans

Plasma renin test guided drug treatment algorithm for correcting different subtypes of hypertension in treated but uncontrolled patients Background and study aims High blood pressure (hypertension), if untreated, increases the risk of serious problems such as heart attacks and strokes. Medication remains the mainstay of treatment, and its benefits are gained mostly from lowering blood pressure; however, the control rates of blood pressure remain unsatisfactory worldwide, which is at least in part due to a lack of methods to select an efficient antihypertensive drug(s) for a individual patient from the numerous drugs available. To this end, an approach for selecting anti-hypertensive drugs called the renin test guided therapeutic (RTGT) algorithm has been demonstrated to work better than standard care in patients with treated but uncontrolled hypertension. The aim of this study is to examine whether the blood pressure lowering ability of this approach varies according to the different types of hypertension, namely isolated diastolic hypertension (IDH), systolic diastolic hypertension (SDH) and isolated systolic hypertension (ISH). Who can participate? Patients aged 18 or over with hypertension who are not currently taking anti-hypertensive medication What does the study involve? In the first visit, the patient’s blood pressure is recorded and they are classified into one of the three hypertension types. They are then prescribed with one of two antihypertensive drugs depending on their blood pressure. At the second visit scheduled 2 weeks later, patients whose blood pressure reached the target level are excluded from the study to ensure that the patients being further tested are those with treated but uncontrolled hypertension with their original hypertension types. A blood sample is taken for the plasma renin activity (PRA) test. The patients are then randomly allocated to be treated with antihypertensive drugs according to the RTGT algorithm or senior general cardiologist’s care (SGCC), where the drugs are chosen based on the physician’s personal judgment unaware of the patient’s PRA values. The changes in blood pressure levels and antihypertensive drugs between the second and the last visit are compared between the RTGT and SGCC groups and between the three types of hypertension. What are the possible benefits and risks of participating? Patients in the RTGT group may benefit from lower blood pressure and/or may need fewer anti-hypertensive drugs to control their blood pressure compared with the SGCC group receiving drug treatment as usual. The only anticipated risk for the participants is the possibility that their blood pressure remains high or rises during the study leading to heart complications, but the chances are minor because the antihypertensive drug(s) are continuously given during the study. Where is the study run from? Second Hospital of Hebei Medical University (China) When is the study starting and how long is it expected to run for? November 2009 to June 2012 Who is funding the study? Hebei Science and Technology Agency (China) Who is the main contact? 1. Prof. Zejun Tian 2. Prof. Yuming Hao [email protected]

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