Patient case (clinical description): A 66-year-old woman comes to the office due to joint pain in the hands and periodic morning stiffness that lasts less than 15 minutes.  The pain is moderately severe and worsens with daily activity. The patient used Tylenol with minimal relief.  Past medical history is notable for hypertension and hypercholesteremia.  Physical examination shows firm nodules over the distal interphalangeal joints, bilaterally. The patient has pain in her knees as well. The knees are stiff in the morning for less than 30 minutes and become worse with climbing stairs. She has some sensation of bone friction during activity. X-ray shows narrowing of the joint space, subchondral bone sclerosis and osteophyte formation along the joints.

Patient's own account: I'm a 66-year-old woman and I went to my doctor's office because of a bloody joint pain in my hands that has been lasting for a while. The pain comes and go in the morning usually. I feel like a stiffness that last less than 15 minutes. The pain is moderately severe but it gets worse when I'm using my hands. I used Tylenol which helped a little. Apart from that, I suffer from hypertension and high cholesterol. The doctor made me notice that I have bumps around both of my hand joints. I also suffer from my knees and they are also stiff in the morning for around 30 min. It's even worse when I climb up the stairs! I also feel like my bones are rubbing against each other when I'm moving. The X-ray showed that I have narrow joint space, I have sclerosis, and abnormal growths of bone along my joints.

Clinical trial: Angiotensin 1-7 in Obesity Hypertension

Eligibility criteria:
Inclusion Criteria:

          -  Men and women of all races

          -  Capable of giving informed consent

          -  Age 18-60 years

          -  Body mass index (BMI) between 30-40 kg/m2

          -  Hypertension defined as two or more seated blood pressure readings >130/80 mmHg or use
             of anti-hypertensive medications

          -  Satisfactory history and physical exam

        Exclusion Criteria:

          -  Age ≤ 17 or ≥ 61 years

          -  Pregnant or nursing women

          -  Decisional impairment

          -  Prisoners

          -  Alcohol or drug abuse

          -  Current smokers

          -  Highly trained athletes

          -  Subjects with >5% weight change in the past 3 months

          -  Evidence of type I or type II diabetes (fasting glucose > 126 mg/dL or use of
             anti-diabetic medications)

          -  History of serious cardiovascular disease (e.g. myocardial infarction within 6 months,
             symptomatic coronary artery disease, presence of angina pectoris, significant
             arrhythmia, congestive heart failure, deep vein thrombosis, pulmonary embolism, second
             or third degree heart block, mitral valve stenosis, aortic stenosis, hypertrophic
             cardiomyopathy) or cerebrovascular disease (e.g. cerebral hemorrhage, stroke,
             transient Ischemic attack).

          -  History or presence of immunological or hematological disorders

          -  Impaired hepatic function (AST or ALT levels >2 times upper limit of normal range)

          -  Impaired renal function (serum creatinine >2.0 mg/dl)

          -  Anemia

          -  Treatment with serotonin-norepinephrine reuptake inhibitors (SNRIs) or norepinephrine
             transporter (NET) inhibitors

          -  Treatment with phosphodiesterase-5 inhibitors

          -  Treatment with anticoagulants (e.g. warfarin)

          -  Treatment with chronic systemic glucocorticoid therapy (>7 consecutive days in 1
             month)

          -  Treatment with any investigational drug in the 1-month preceding the study

          -  Inability to give, or withdraw, informed consent
No condition on gender to be admitted to the trial.
No healthy subjects accepted to join the trial.
Subject must be at least 18 Years old.
Subject must be at most 60 Years

Eligibility (NLI label): Contradiction