New Biomarkers and Difficult-to-treat Hypertension
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The purpose of this study is to determine the concentrations and variabilities of urinary exosomal sodium channels and plasma angiotensins in patients with difficult-to-treat arterial hypertension and to investigate their dependency on clinical parameters and sampling conditions.
Plasma concentration of Ang peptides [ Time Frame: 2nd scheduled visit (5 days to 4 weeks after 1st visit) ]
Urinary concentration of exosomal Na channel proteins [ Time Frame: 2nd scheduled visit (5 days to 4 weeks after 1st visit) ]
Secondary Outcome Measures :
24h urinary Na excretion [ Time Frame: 2nd scheduled visit (5 days to 4 weeks after 1st visit) ]
Plasma renin concentration [ Time Frame: 2nd scheduled visit (5 days to 4 weeks after 1st visit) ]
Plasma aldosterone concentration [ Time Frame: 2nd scheduled visit (5 days to 4 weeks after 1st visit) ]
Repeatability of Ang peptide and urinary exosomal Na channel concentrations under spontaneous vs. standardized laboratory conditions. [ Time Frame: 1st visit vs. 2nd scheduled visit (5 days to 4 weeks after 1st visit) ]
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Ages Eligible for Study:
18 Years and older (Adult, Older Adult)
Sexes Eligible for Study:
Accepts Healthy Volunteers:
Amblatory patients with difficult-to-treat hypertension referred to the hypertension clinic for evaluation
Patients with ≥2 antihypertensive drugs for ≥3 months
Reported blood pressure ≥140/90 mmHg and/or patient reported as having medically uncontrolled hypertension by the referring physician
Age ≥18 years, capacity to provide and granted written informed consent
Chronic stage 4-5 renal insufficiency; glomerulonephritis, liver insufficiency (Child-Pugh B or C), chronic obstructive pulmonary disease Global Initiative for Obstructive Lung Disease grade 4; chronic heart failure New York Heart Association class IV
Known secondary hypertension
Mandatory RAAS-blockers (e.g. converting enzyme inhibitors, angiotensin type 1 receptor blockers), beta-adrenoceptor blockers, centrally acting sympatholytics and diuretics that cannot be paused adequately before visit 2
Mean sitting office blood pressure >190/110 mmHg measured 3x on visit 1
Individual Participant Data (IPD) Sharing Statement:
Plan to Share IPD:
Interested third parties may have access to project data by contacting the leading investigator. Only anonymous data are shared, also in case with third parties with lower data protection standards than Swiss or European Union, to safeguard confidentiality.
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Studies a U.S. FDA-regulated Drug Product:
Studies a U.S. FDA-regulated Device Product:
Keywords provided by University Hospital Inselspital, Berne: