URIC ACID AND HYPERTENSION IN AFRICAN-AMERICANS

这个子项目是许多研究子项目中利用 资源由NIH/NCRR资助的中心拨款提供。子项目和 调查员(PI)可能从NIH的另一个来源获得了主要资金， 并因此可以在其他清晰的条目中表示。列出的机构是 该中心不一定是调查人员的机构。 噻嗪类利尿剂用于治疗高血压时，与许多代谢副作用有关，包括高尿酸血症、痛风、胰岛素抵抗和高脂血症。这些情况在非裔美国人中都已经非常普遍了。我们的假设是，噻嗪诱导的高尿酸血症降低了噻嗪类药物控制血压的效果，导致内皮功能障碍，并增加了胰岛素抵抗和糖耐量受损的发生率。这一假设将在为期8周的随机双盲安慰剂对照2因子临床试验中得到验证。在该试验中，总共300名血压为140-159/90-99毫米汞柱的1期高血压的非裔美国患者将被分配到四种方案中的一种：一种类似噻嗪的利尿剂，氯苯吡酮25毫克/天，以及黄嘌呤酶抑制剂别嘌醇；氯苯妥酮25毫克/天和安慰剂；安慰剂；或别嘌醇与低钠饮食相结合。主要终点是收缩压降低。次级终点测量内皮功能、动态血压、身体成分、全身炎症、代谢参数、氧化应激和肾脏血流动力学。

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. Thiazide diuretics when used in the treatment of hypertension are associated with many metabolic side effects including hyperuricemia, gout, insulin resistance, and hyperlipidemia. Each of these conditions is already highly prevalent in African-Americans. Our hypothesis is that thiazide-induced hyperuricemia decreases the efficacy of thiazides in controlling BP, leads to endothelial dysfunction, and increases the incidence of insulin resistance and impaired glucose tolerance. This hypothesis will be tested in a randomized double-blind placebo-controlled 2 ¿ 2 factorial clinical trial of 8-week duration in which a total of 300 African-Americans patients with stage 1 hypertension, BP: 140-159/90-99 mm Hg, will be assigned to one of four regimens: a thiazide-like diuretic, chlorthalidone 25 mg/day, and a xanthine oxidase inhibitor, allopurinol; chlorthalidone 25 mg/day and placebo; placebo; or allopurinol in conjunction with a low-sodium diet. The primary end-point is reduction in systolic BP. Secondary end-points measure endothelial function, ambulatory blood pressure, body composition, systemic inflammation, metabolic parameters, oxidant stress and renal hemodynamics.