Clinical trial NCT02759276: Microcirculation and Inflammatory Markers in Patients With Resistant, Stages 1/2 Hypertension and Normal Blood Pressure
Official title: Inflammatory Biomarkers and Endothelial Function Assessed by Venous Occlusion Plethysmography and Nailfold Videocapillaroscopy in Patients With Resistant Hypertension, Stages 1 and 2 and Normotensive
Study type: OBSERVATIONAL
Overall status: COMPLETED
Conditions: High Blood Pressure
Keywords: Nailfold Videocapillaroscopy
Venous Occlusion Plethysmography
Endothelial Function
Microcirculation
Inflammatory Biomarkers
Lead sponsor: Rio de Janeiro State University
Sponsor class: OTHER
Collaborators: name: Rio de Janeiro State University
First posted: 2016-05-03
Enrollment: 75
Sex: ALL
Minimum age (years): 27
Maximum age (years): 65
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: yes
Time perspective: CROSS_SECTIONAL
Sampling method: NON_PROBABILITY_SAMPLE
Study population: First Day: Full clinical examination was performed, including measurements of at-rest blood pressure, weight and height in order to calculate Body Mass Index (BMI), waist and hip measurements.

Second Day: drawing blood for laboratory analyses, Nailfold Videocapillaroscopy and Venous Occlusion Plethysmography.

Brief summary: Nailfold videocapillaroscopy (NVC), Venous occlusion Plethysmography (VOP) and inflammatory biomarkers have been used to study endothelial function in patients with resistant hypertension, stages 1 and 2 hypertension and normotensive. This was a cross-sectional study.

Detailed description: Microcirculation determines peripheral resistance contributing to increased blood pressure. The nailfold videocapillaroscopy (NVC), Venous occlusion Plethysmography (VOP) and biomarkers can be used to evaluate the microcirculation in arterial hypertension (AH). The objective of this study is to analyze the behavior of serum inflammatory markers and study the microcirculation by nailfold videocapillaroscopy (NVC) and Venous Occlusion Plethysmography in patients with resistant hypertension (RH), with stages 1 and 2 hypertension (MMH ) and normotensive (CG). A cross-sectional study with 75 patients has been performed: 25 with resistant hypertension (RH), 25 with stages 1 and 2 hypertension (MMH) and 25 normotensive (CG). All underwent anamnesis, dosage serum markers and conducting NVC, VOP. Hypertensive patients without statin use and with controlled or uncontrolled blood pressure were also analyzed. For the statistical analysis were used: Kruskal -Wallis ANOVA, Dunn test and ANCOVA for correction of confusion factors such as age and BMI.

Eligibility criteria: Inclusion Criteria:

* Clinical diagnosis of controlled High Blood Pressure stages 1 and 2 (blood pressure levels from 140/90 mmHg to 179/109 mmHg) .
* Resistant Hypertension (uncontrolled hypertension, with values ≥140/90 mmHg, using three or more antihypertensive drugs of different classes, including a diuretic, or controlled hypertension with four or more drugs).
* Normal Blood Pressure.

Exclusion Criteria:

* Diabetes Mellitus, Types 1 or 2.
* Heart Failure.
* Myocardial infarction or stroke with less than three months of the event.
* Chronic kidney disease.
* Use of hormonal or non-hormonal anti-inflammatory drugs.
* Recent trauma (less than three months).
* Autoimmune diseases.
* Infectious processes in activity.
* Neoplasia.
* Aspirin use (anti-inflammatory dose).
* Obesity grade III (Body Mass Index\>40 kg/m2).

Primary outcomes:
measure: Blood Pressure (mmHg)
timeFrame: 1 day
Secondary outcomes:
measure: Functional Capillary Density (FCD, number capillaries/mm2 )
timeFrame: 1 day
measure: Afferent Capillary Diameter (micrometer)
timeFrame: 1 day
measure: Apical Capillary Diameter (micrometer)
timeFrame: 1 day
measure: Efferent Capillary Diameter (micrometer)
timeFrame: 1 day
measure: Red Blood Cell Velocity (mm/s)
timeFrame: 1 day
measure: Maximum Red Blood Cell Velocity (mm/s)
timeFrame: 1 day
measure: Time to reach Maximum Red Blood Cell Velocity (s)
timeFrame: 1 day
measure: Waist circumference (cm)
timeFrame: 1 day
measure: Hip circumference (cm)
timeFrame: 1 day
measure: Waist to Hip Ratio
timeFrame: 1 day
measure: Body Mass Index (Kg/m2)
timeFrame: 1 day
measure: Maximal Forearm Blood Flow during reactive Hyperemia
timeFrame: 1 day
measure: Maximal Forearm Blood Flow after sublingual nitroglycerine
timeFrame: 1 day
measure: Vascular Cell Adhesion Molecule (VCAM, ng/dl)
timeFrame: up to 2 weeks
measure: Intercellular Adhesion Molecule (ICAM, ng/dl)
timeFrame: up to 2 weeks
measure: Adiponectin (ng/dl)
timeFrame: up to 2 weeks
measure: Endothelin (pg/dl)
timeFrame: up to 2 weeks
measure: C Reactive Protein (CRP, mg/dl)
timeFrame: up to 2 weeks
Other outcomes:
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