Please select the arm or intervention descriptions that belong to the clinical trial below.
Title: Aldosterone-induced Microvascular Dysfunction as a Cause of Salt-sensitivity in Obesity?
Brief Summary: Currently, the incidence of obesity and obesity-related disorders is reaching epidemic proportions, which entails an increasing burden for health care systems. The association of obesity with other risk factors for type 2 diabetes mellitus and cardiovascular disease, such as insulin resistance and hypertension, is often referred to as the metabolic syndrome. During recent years, salt-sensitivity of blood pressure has emerged as an additional cardiovascular risk factor that is related to obesity and other key components of the metabolic syndrome. The underlying pathophysiological mechanisms of these interrelationships are complex and incompletely elucidated. Microvascular dysfunction has been proposed as a link between insulin resistance and hypertension in obese individuals. In addition, impairment of microvascular function was found to be associated with salt-sensitivity of blood pressure. Increased aldosterone levels, as observed in obese individuals, might be a cause of microvascular dysfunction-induced salt-sensitivity and insulin resistance. Aldosterone not only gives rise to sodium-retention in the distal tubule of the kidney, but was also found to impair endothelial function and thus lower NO-availability, which is characteristic of microvascular dysfunction. In addition, elevated aldosterone levels are associated with both hypertension and insulin resistance, which is illustrated in patients with primary aldosteronism, but also in the general population.

The investigators hypothesize that increased aldosterone levels in obese individuals lead to impairment of microvascular function through reduction of NO-availability. This microvascular dysfunction is suggested to play a central role in the pathogenesis of salt-sensitive hypertension and insulin resistance.


Options:
A: Arm Label: Baseline; Type: ACTIVE_COMPARATOR; Interventions: Drug: Acetylcholine (ACh) Dose Response, Drug: Local Heating (LH), Drug: Flow Mediated Dilation with nitroglycerin | Arm Label: Low Sodium, No Cheese; Type: EXPERIMENTAL; Interventions: Drug: Acetylcholine (ACh) Dose Response, Drug: Local Heating (LH), Drug: Flow Mediated Dilation with nitroglycerin | Arm Label: Low Sodium, Cheese; Type: EXPERIMENTAL; Interventions: Drug: Acetylcholine (ACh) Dose Response, Drug: Local Heating (LH), Drug: Flow Mediated Dilation with nitroglycerin | Arm Label: High Sodium, No Cheese; Type: EXPERIMENTAL; Interventions: Drug: Acetylcholine (ACh) Dose Response, Drug: Local Heating (LH), Drug: Flow Mediated Dilation with nitroglycerin | Arm Label: High Sodium, Cheese; Type: EXPERIMENTAL; Interventions: Drug: Acetylcholine (ACh) Dose Response, Drug: Local Heating (LH), Drug: Flow Mediated Dilation with nitroglycerin | Intervention Type: DRUG; Name: Acetylcholine (ACh) Dose Response; Assigned to Arm(s): Baseline, High Sodium, Cheese, High Sodium, No Cheese, Low Sodium, Cheese, Low Sodium, No Cheese | Intervention Type: DRUG; Name: Local Heating (LH); Assigned to Arm(s): Baseline, High Sodium, Cheese, High Sodium, No Cheese, Low Sodium, Cheese, Low Sodium, No Cheese | Intervention Type: DRUG; Name: Flow Mediated Dilation with nitroglycerin; Assigned to Arm(s): Baseline, High Sodium, Cheese, High Sodium, No Cheese, Low Sodium, Cheese, Low Sodium, No Cheese
B: Intervention Type: BEHAVIORAL; Name: Low Salt Diet versus High salt diet; Assigned to Arm(s): N/A
C: Arm Label: Start with low-sodium diet; Type: ACTIVE_COMPARATOR; Interventions: Dietary Supplement: Low-sodium diet, Dietary Supplement: High-sodium diet | Arm Label: Start with high-sodium diet; Type: ACTIVE_COMPARATOR; Interventions: Dietary Supplement: Low-sodium diet, Dietary Supplement: High-sodium diet | Intervention Type: DIETARY_SUPPLEMENT; Name: Low-sodium diet; Assigned to Arm(s): Start with high-sodium diet, Start with low-sodium diet | Intervention Type: DIETARY_SUPPLEMENT; Name: High-sodium diet; Assigned to Arm(s): Start with high-sodium diet, Start with low-sodium diet
D: Arm Label: Control; Type: OTHER; Interventions: Other: Control | Arm Label: Salt reduction; Type: EXPERIMENTAL; Interventions: Behavioral: Salt reduction | Intervention Type: BEHAVIORAL; Name: Salt reduction; Assigned to Arm(s): Salt reduction | Intervention Type: OTHER; Name: Control; Assigned to Arm(s): Control

Answer: C