Title
Influence of altitude on hypertension phenotypes and responses to antihypertensive therapy: Review of the literature and design of the INTERVENCION trial
Date Issued
01 October 2020
Access level
open access
Resource Type
review
Author(s)
Medina-Lezama J.
Narvaez-Guerra O.
Chirinos J.A.
Santa Maria Catholic University School of Medicine
Publisher(s)
Blackwell Publishing Inc.
Abstract
Systemic arterial hypertension constitutes the leading cause of mortality worldwide, and affects people living at different altitudes above sea level (AASL). AASL has a major impact on cardiovascular function and various biologic pathways that regulate blood pressure–related phenotypes, but whether it affects the clinical response to antihypertensive therapy is unknown. The hemodynamic adaptations observed among lowlanders acutely exposed to high altitude (HA) is distinct from those observed among HA dwellers. However, the phenotypic patterns of hypertension and the response to standard antihypertensive agents among adults chronically exposed to different AASL are poorly understood. The authors describe the protocol for the INTERVENCION trial, a randomized clinical trial designed to assess the effects of three first-line antihypertensive monotherapies (a thiazide diuretic, an angiotensin receptor blocker, and a calcium channel blocker) on peripheral and central blood pressure, in-office blood pressure, and ambulatory blood pressure hemodynamics of hypertensive patients living at different AASL (low altitude, intermediate altitude, and high altitude). The primary end point is the reduction in 24-hour brachial systolic blood pressure. The INTERVENCION trial will provide the first clinical trial data regarding the influence of AASL on the response to antihypertensive monotherapy, as well as the hemodynamic characteristics of arterial hypertension at different AASL.
Start page
1757
End page
1762
Volume
22
Issue
10
Language
English
OCDE Knowledge area
Sistema cardiaco, Sistema cardiovascular Fisiología
Scopus EID
2-s2.0-85091043303
PubMed ID
Source
Journal of Clinical Hypertension
ISSN of the container
15246175
Sponsor(s)
JAC is supported by NIH grants R01‐HL 121510‐01A1, R61‐HL‐146390, R01‐AG058969, 1R01‐HL104106, P01‐HL094307, R03‐HL146874‐01, and R56‐HL136730. He has received consulting honoraria from Sanifit, Microsoft, Fukuda‐Denshi, Bristol‐Myers Squibb, OPKO Healthcare, Ironwood Pharmaceuticals, Pfizer, Akros Pharma, Merck, Edwards Lifesciences, Bayer, and JNJ. He has received research grants from the NIH, Microsoft, Fukuda‐Denshi, and Bristol‐Myers Squibb and device loans from Atcor Medical, Fukuda‐Denshi, and Microvision. He is named as inventor in an UPenn patent for the use of inorganic nitrates/nitrites for the treatment of HF and preserved ejection fraction and a patent application for the use of novel neoepitope biomarkers of tissue fibrosis in heart failure. Other authors have no disclosures. The trial protocol was approved by the Ethics Committee and Institutional Review Board of Carlos Alberto Seguin Escobedo National Hospital EsSALUD, Arequipa, Peru. The study was sponsored by the Santa Maria Catholic University of Arequipa, and the Peruvian Society of Cardiology. The trial is registered at ClinicalTrials.gov with trial ID NCT02373163. Farmindustria (Lima, Peru) provided the study medications at no cost. AtCor Medical provided Sphygmocor PVx devices for the trial at no cost.
Sources of information: Directorio de Producción Científica Scopus