Mechanisms of Increased Ambulatory Blood Pressure in Patients With Intradialytic Hypertension
| Status: | Completed |
|---|---|
| Conditions: | High Blood Pressure (Hypertension) |
| Therapuetic Areas: | Cardiology / Vascular Diseases |
| Healthy: | No |
| Age Range: | 18 - 80 |
| Updated: | 5/3/2018 |
| Start Date: | January 2013 |
| End Date: | April 2018 |
Mechanism of Increased Ambulatory Blood Pressure in Patients With Intradialytic Hypertension and Hemodialysis Controls: A Case Control Study and Crossover Trial Comparing Carvedilol and Prazosin Hydrochloride
The purpose of this study is 1) to determine what physiologic factors (extracellular fluid
overload or vasoconstriction) contribute more to increased blood pressure levels between
dialysis treatments in hemodialysis patients whose blood pressure increases and decreases
during hemodialysis and 2) to determine whether carvedilol provides better control of blood
pressure between dialysis treatments than prazosin in patients whose blood pressure increases
during dialysis.
overload or vasoconstriction) contribute more to increased blood pressure levels between
dialysis treatments in hemodialysis patients whose blood pressure increases and decreases
during hemodialysis and 2) to determine whether carvedilol provides better control of blood
pressure between dialysis treatments than prazosin in patients whose blood pressure increases
during dialysis.
Inclusion Criteria (for Aims 1 and 2):
- age more than 18 years
- Hypertension defined as systolic blood pressure more than 140 mmHg before dialysis or
more than 130 mmHg after dialysis
- For case subjects with intradialytic hypertension: systolic blood pressure increase
more than 10 mmHg from pre to post dialysis in at least 4 out of 6 screening
treatments
- For control subjects: systolic blood pressure decrease more than 10 mmHg from pre to
post dialysis in at least 4 out of 6 screening treatments
Inclusion criteria for Aim 3 includes the case subjects described above.
Exclusion Criteria:
For Aims 1 and 2:
- Hemodialysis vintage less than 1 month
- Amputated arm or leg
- Presence of cardiac defibrillator or pacemaker
- Presence of large metal prosthesis
- Failure to achieve dry weight
For Case subjects participating in Aim 3:
- Patients with a specific indication for beta blocker therapy including systolic heart
failure, history of myocardial infarction, history of tachyarrhythmia or angina being
managed with beta blocker therapy.
- Patients with contraindications to beta blockade including bradycardia (heart rate
less than 60 beats per minute) while not on a pulse lowering drug, severe reactive
airway disease, prior intolerance to beta blocker therapy
- Prior intolerance to alpha blocker therapy
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Univ of Texas, Southwestern Med Ctr of Dallas The story of UT Southwestern Medical Center...
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