Resistant hypertension and primary hypertension
Conditions
Interventions
RDN group:Renal denervation
RDN control group:Conventional pharmacological therapy.
Lifestyle intervention group:Regular aerobic exercise, e.g., walking and swimming, plus a low - salt diet, sleep apnea syndrome treatment, and medication adherence education.
Lifestyle control group:Continue with the routine lifestyle and receive conventional treatment.
The ARNI ± CCB ± DU group:First, use ARNI. When a drug combination is necessary, choose to combine it with CCBs (ARNI + CCB). If the blood pressure still fails to reach the target level after combinin
Control group of the original antihypertensive regimen:Continue to use the original antihypertensive medications
Sponsors
The West China Hospital of Sichuan University
Eligibility
Sex/Gender
All
Inclusion criteria
Inclusion criteria: Exploration of the efficacy and safety of RDN in patients with refractory hypertension in plateau areas 1. Individual age>= 18 years and =160 mmHg based on the average of the 3 blood pressure readings measured at the initial screening visit and the confirmatory screening visit; 4. Agree to sign the informed consent form and be willing to follow up according to the follow-up plan. An exploration of the effectiveness of lifestyle interventions for patients with essential hypertension in plateau areas 1. Applicants must be over 18 years old and under 75 years old (including 75 years old), regardless of gender; 2. Definite diagnosis of refractory hypertension; 3. The patient agrees to participate in this clinical trial and sign the informed consent form, agrees to conduct follow-up evaluation in accordance with the requirements of the validation protocol. Exploration of antihypertensive regimen for patients with essential hypertension in plateau area 1. Applicants must be over 18 years old and under 80 years old (including 80 years old); 2. Clear diagnosis of essential hypertension; 3. The patient agrees to participate in this clinical trial and sign the informed consent form, agrees to conduct follow-up evaluation in accordance with the requirements of the validation protocol.
Exclusion criteria
Exclusion criteria: Exploration of the efficacy and safety of RDN in patients with refractory hypertension in plateau areas 1. Ambulatory blood pressure monitoring (ABPM) 24-hour mean SBP 5.5mmoL/L; Upper limit of normal × aspartate and/or alanine aminotransferase >3.0; 4. Patients with acute coronary syndrome, pulmonary embolism, aortic dissection, cerebral hemorrhage, massive cerebral infarction, and malignant tumors within 3 months; 5. Patients who have received hemodialysis or strict salt restriction therapy; 6. Gastrointestinal diseases or postoperative absorption and excretion of the digestive tract have certain effects, such as gastrointestinal resection, active gastrointestinal inflammation, ulcer or gastrointestinal bleeding; 7. Women who are pregnant or breastfeeding. Exploration of antihypertensive regimen for patients with essential hypertension in plateau area 1. History of angioedema, drug-related or other reasons; 2. Renal artery stenosis; 3. Patients with immune system disorders; 4. Abnormal serum potassium and liver function: serum potassium > 5.5mmoL/L; Upper limit of normal × aspartate and/or alanine aminotransferase >3.0; 5. Abnormal renal function: estimated glomerular filtration rate <30ml/ (min·1.73m^2); 6. Patients with acute coronary syndrome, pulmonary embolism, aortic dissection, cerebral hemorrhage, massive cerebral infarction, and malignant tumor within 3 months; 7. Patients receiving hemodialysis or strict salt restriction therapy; 8. Gastrointestinal diseases or gastrointestinal surgery have a certain impact on the absorption and excretion of drugs, such as gastrointestinal resection, active gastrointestinal inflammation, ulcer or gastrointestinal bleeding; 9. Pregnant or lactating women.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Office Blood Pressure;serum creatinine;Estimated glomerular Filtration Rate (eGFR);Computed Tomography Angiography of Renal Artery;Renal Artery Ultrasonography;Urinary albumin creatinine ratio;urine microalbumin;urine sodium;Blood catecholamines and their metabolites;Physiological fluctuation of cortisol; | — |
Countries
China
Contacts
Public ContactYong Peng
The West China Hospital of Sichuan University
Outcome results
None listed