Evidence map›Paper›PMID 29433578›Full record

ArticleTrials2018

Resistant Hypertension On Treatment (ResHypOT): sequential nephron blockade compared to dual blockade of the renin-angiotensin-aldosterone system plus bisoprolol in the treatment of resistant arterial hypertension - study protocol for a randomized controlled trial.

Elizabeth do Espirito Santo Cestário, Letícia Aparecida Barufi Fernandes, Luiz Tadeu Giollo-Júnior, Jéssica Rodrigues Roma Uyemura, Camila Suemi Sato Matarucco, Manoel Idelfonso Paz Landim, Luciana Neves Cosenso-Martin, Lúcia Helena Bonalume Tácito, Heitor Moreno, José Fernando Vilela-Martin and 1 more

Registry-linked trialOpen access · goldAbstract readClinical Trial Protocol
In one paragraph

Article in Trials, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02832973 (Resistant Hypertension On Treatment - Sequential Nephron Blockade Compared to Dual Blockade of the Renin-angiotensin-aldosterone System Plus Bisoprolol in the Treatment of Resistant Arterial Hypertension), which is not on this map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
0.5field-weighted citation impact, top 32% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT02832973 phase4completednot on this map

Resistant Hypertension On Treatment - Sequential Nephron Blockade Compared to Dual Blockade of the Renin-angiotensin-aldosterone System Plus Bisoprolol in the Treatment of Resistant Arterial Hypertension: A Randomized Trial (ResHypOT)

TypeinterventionalSponsorSao Jose do Rio Preto Medical SchoolRan2015 to 2018Enrolled72ConditionsHypertension Resistant to Conventional TherapyArmsSpironolactone, Furosemide,, Amiloride, Ramipril, Bisoprolol
3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 6 citations in OpenAlex.

  1. Trial
  2. Trial
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors at 2 institutions in 1 country.

Elizabeth do Espirito Santo CestárioHypertension Clinic, Department of Internal Medicine, State Medical School of São José do Rio Preto (FAMERP), Rua Tocantins 2971 Votuporanga, São Paulo, CEP 15505-188, Brazil. cestario@cardiol.br.
Letícia Aparecida Barufi FernandesHypertension Clinic, Department of Internal Medicine, State Medical School of São José do Rio Preto (FAMERP), Rua Tocantins 2971 Votuporanga, São Paulo, CEP 15505-188, Brazil.
Luiz Tadeu Giollo-JúniorHypertension Clinic, Department of Internal Medicine, State Medical School of São José do Rio Preto (FAMERP), Rua Tocantins 2971 Votuporanga, São Paulo, CEP 15505-188, Brazil.
Jéssica Rodrigues Roma UyemuraHypertension Clinic, Department of Internal Medicine, State Medical School of São José do Rio Preto (FAMERP), Rua Tocantins 2971 Votuporanga, São Paulo, CEP 15505-188, Brazil.
Camila Suemi Sato MataruccoHypertension Clinic, Department of Internal Medicine, State Medical School of São José do Rio Preto (FAMERP), Rua Tocantins 2971 Votuporanga, São Paulo, CEP 15505-188, Brazil.
Manoel Idelfonso Paz LandimHypertension Clinic, Department of Internal Medicine, State Medical School of São José do Rio Preto (FAMERP), Rua Tocantins 2971 Votuporanga, São Paulo, CEP 15505-188, Brazil.
Luciana Neves Cosenso-MartinHypertension Clinic, Department of Internal Medicine, State Medical School of São José do Rio Preto (FAMERP), Rua Tocantins 2971 Votuporanga, São Paulo, CEP 15505-188, Brazil.
Lúcia Helena Bonalume TácitoEndocrinology Division of the Internal Medicine Department, State Medical School of São José Rio Preto (FAMERP), São Paulo, Brazil.
Heitor MorenoCardiovascular Pharmacology Laboratory, Faculty of Medical Sciences, State University of Campinas (UNICAMP), Campinas, Brazil.
José Fernando Vilela-MartinHypertension Clinic, Department of Internal Medicine, State Medical School of São José do Rio Preto (FAMERP), Rua Tocantins 2971 Votuporanga, São Paulo, CEP 15505-188, Brazil.
Juan Carlos Yugar-ToledoHypertension Clinic, Department of Internal Medicine, State Medical School of São José do Rio Preto (FAMERP), Rua Tocantins 2971 Votuporanga, São Paulo, CEP 15505-188, Brazil.
Faculdade de Medicina de São José do Rio Preto · BRUniversidade Estadual de Campinas (UNICAMP) · BR

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundResistant hypertension is characterized when the blood pressure (BP) remains above the recommended goal after taking three antihypertensive drugs with synergistic actions at their maximum recommended tolerated doses, preferably including a diuretic. Identifying the contribution of intravascular volume and serum renin in maintaining BP levels could help tailor more effective hypertension treatment, whether acting on the control of intravascular volume or sodium balance, or acting on the effects of the renin-angiotensin-aldosterone system (RAAS) on the kidney. METHODS/

designThis is a randomized, open-label, clinical trial is designed to compare sequential nephron blockade and its contribution to the intravascular volume component with dual blockade of the RAAS plus bisoprolol and the importance of serum renin in maintaining BP levels. The trial has two arms: sequential nephron blockade versus dual blockade of the RAAS (with an angiotensin converting enzyme (ACE) inhibitor plus a beta-blocker) both added-on to a thiazide diuretic, a calcium-channel blocker and an angiotensin receptor-1 blocker (ARB). Sequential nephron blockade consists in a progressive increase in sodium depletion using a thiazide diuretic, an aldosterone-receptor blocker, furosemide and, finally, amiloride. On the other hand, the dual blockade of the RAAS consists of the progressive addition of an ACE inhibitor until the maximum dose and then the administration of a beta-blocker until the maximum dose. The primary outcomes will be reductions in the systolic BP, diastolic BP, mean BP and pulse pressure (PP) after 20 weeks of treatment. The secondary outcomes will evaluate treatment safety and tolerability, biochemical changes, evaluation of renal function and recognition of hypotension (ambulatory BP monitoring (ABPM)). The sample size was calculated assuming an alpha error of 5% to reject the null hypothesis with a statistical power of 80% giving a total of 40 individuals per group. DISCUSSION: In recent years, the cost of resistant hypertension (RH) treatment has increased. Thus, identifying the contribution of intravascular volume and serum renin in maintaining BP levels could help tailor more effective hypertension treatment, whether by acting on the control of intravascular volume or sodium balance, or by acting on the effects of the RAAS on the kidney.

trial registrationSequential Nephron Blockade vs. Dual Blockade Renin-angiotensin System + Bisoprolol in Resistant Arterial Hypertension (ResHypOT). ClinicalTrials.gov, ID: NCT02832973 . Registered on 14 July 2016. First received: 12 June 2016. Last updated: 18 July 2016.

Indexed as

AdolescentAdrenergic beta-1 Receptor AntagonistsAdultAgedAngiotensin-Converting Enzyme InhibitorsAngiotensin Receptor AntagonistsAntihypertensive AgentsArterial PressureBisoprololBrazilCalcium Channel BlockersDrug ResistanceDrug Therapy, CombinationFemaleHumansHypertensionAdrenergic beta-1 Receptor AntagonistsAngiotensin-Converting Enzyme InhibitorsAngiotensin Receptor AntagonistsAntihypertensive AgentsBisoprololCalcium Channel BlockersSodium Chloride Symporter InhibitorsBisoprololDual blockade of the renin-angiotensin systemNatriuretic agentsResistant hypertension

Identifiers

PMID29433578
PMCPMC5810004
OpenAlexW2790105452

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.