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Changes After Angiotensin Converting Enzyme (ACE) Inhibitor Replacement by Angiotensin II Receptor Type I (AT1) Blocker (ADIRAS)

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details. Identifier: NCT01444833
Recruitment Status : Unknown
Verified September 2011 by Stefan Zorad, Slovak Academy of Sciences.
Recruitment status was:  Recruiting
First Posted : October 3, 2011
Last Update Posted : October 3, 2011
Information provided by (Responsible Party):
Stefan Zorad, Slovak Academy of Sciences

Brief Summary:
It is supposed that the significant metabolic effects (improvement of insulin sensitivity) of hypertension therapy with renin-angiotensin system (RAS) blockers in humans are mediated mainly via changes in abdominal adipose tissue. This project is aimed to confirm the hypothesis that increased concentrations of circulatory angiotensin II after angiotensin II receptor type I (AT1) blockade leads, via stimulation of angiotensin II receptor type II (AT2), to activation of adipogenesis and improvement of insulin sensitivity. Therefore, in hypertensive patients, the components of RAS and the parameters of insulin sensitivity on systemic (in plasma) and local (in adipose tissue and in its interstitial fluid) level will be studied. The main aim of the study is to identify the changes occurring in patient before and 6 months after the conversion of therapy from angiotensin converting enzyme (ACE) inhibitors to AT1 receptor blockers. Observed parameters will include gene expression of RAS components, parameters of insulin sensitivity, amount, and cellularity of adipose tissue obtained by biopsy, evaluation of direct production of cytokines and angiotensins into the interstitial fluid of fat tissue obtained by microdialysis and evaluation of the selected parameters in plasma.

Condition or disease Intervention/treatment Phase
Hypertension Drug: Candesartan Not Applicable

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Study Type : Interventional  (Clinical Trial)
Estimated Enrollment : 35 participants
Intervention Model: Single Group Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: Molecular - Genetic Alterations in Adipose Tissue After Change in Therapy From ACE Inhibitors to AT1 Receptor Blockers in Patients With Essential Hypertension
Study Start Date : October 2008
Actual Primary Completion Date : March 2009
Estimated Study Completion Date : December 2012

Resource links provided by the National Library of Medicine

Intervention Details:
  • Drug: Candesartan
    32 mg per day duration 6 months
    Other Name: Atacand

Primary Outcome Measures :
  1. Systemic Insulin Sensitivity after Replacement of ACE Inhibitor by AT1 Blocker [ Time Frame: 6 months ]
    Oral glucose tolerance test (OGTT) will be used to determine systemic insulin sensitivity.

Secondary Outcome Measures :
  1. Adipocyte Diameter from Subcutaneous Adipose Tissue after Replacement ACE Inhibitor by AT1 Blocker [ Time Frame: 6 months ]
    The tissue obtai ned by biopsy will be digested by collagenase and the diameter of isolated adipocytes will be evaulated by light microscopy.

Information from the National Library of Medicine

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Ages Eligible for Study:   25 Years to 50 Years   (Adult)
Sexes Eligible for Study:   Male
Accepts Healthy Volunteers:   No

Inclusion Criteria:

  • essential hypertension
  • ACE inhibitors

Exclusion Criteria:

  • diabetes mellitus
  • endocrinopathies
  • no smokers

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its identifier (NCT number): NCT01444833

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Contact: Stefan Zorad, Dr. 00421 2 54772800 ext 250
Contact: Adrian Oksa, MD. 00421 2 59370 ext 628

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Institute of Experimental Endocrinology, SAS Recruiting
Bratislava, Slovakia, 833 06
Contact: Stefan Zorad, Dr.    00421 2 54772800 ext 250   
Contact: Adela Penesova, MD.    00421 2 54772800 ext 260   
Principal Investigator: Richard Imrich, MD.         
Principal Investigator: Katarina Krskova, Dr.         
Principal Investigator: Miroslav Vlcek, MD.         
Sub-Investigator: Adrian Oksa, MD.         
Sponsors and Collaborators
Slovak Academy of Sciences
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Principal Investigator: Stefan Zorad, Dr. Institute of Experimental Endocrinology SAS


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Responsible Party: Stefan Zorad, Head of Laboratory, Slovak Academy of Sciences Identifier: NCT01444833    
Other Study ID Numbers: MinHealth
2007/27-SAV-02 ( Other Grant/Funding Number: Slovak Ministry of Health )
First Posted: October 3, 2011    Key Record Dates
Last Update Posted: October 3, 2011
Last Verified: September 2011
Keywords provided by Stefan Zorad, Slovak Academy of Sciences:
Additional relevant MeSH terms:
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Vascular Diseases
Cardiovascular Diseases
Antihypertensive Agents
Angiotensin II Type 1 Receptor Blockers
Angiotensin Receptor Antagonists
Molecular Mechanisms of Pharmacological Action