An interventional study of Chronotherapy in Hypertension, sponsored by Northwell Health. Withdrawn at 1 site in United States. Open to participants aged 18 Years to 70 Years. Per ClinicalTrials.gov, last updated 2013-05-30.
Sponsored by Northwell Health · Not applicable, Interventional, and Treatment
Hypertension (HTN) affects up to 75% of kidney transplant recipients and is associated with premature death. Nocturnal HTN is a common complication of ongoing essential HTN or a secondary cause of HTN. Both the non dipping of systolic blood pressure (SBP) at night time and the reverse dipping is associated with increased target organ damage and adverse cardiovascular outcomes and possibly allograft survival. Treatment of Nocturnal HTN is critical. Chronotherapy has been shown to be effective in halting progression in patients with diabetic nephropathy and chronic kidney disease. There is not enough data on prevalence and management of nocturnal HTN in transplant patients, which is the object of this study.
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Exclusion Criteria:
Patients identified with Nocturnal Hypertension, will have one of the blood pressure medications switched from daytime dosing to nighttime dosing
Drug: Chronotherapy
Patients identified with nocturnal hypertension while treated with blood pressure medications will have one medication switched from daytime to night time dosing in the following preference: 1. ACE or ARB 2. Calcium Channel Blockers 3. Alpha Blocker 4. Beta Blocker If patient is on only one daytime BP medication, it will be switched to night time dosing. No dose adjustments will be made nor any new medications will be added. Only timing of BP medication will be changed.
Percent drop in mean SBP at night time compared to mean SBP at day time
Time frame: 2 months
Urine Microalbumin to creatinine ratio
Time frame: 2 months
Change in Glomerular filtration rate as measured by MDRD equation.
Serum creatinine as a measure of kidney function will be measured at the begining and end of intervention.
Time frame: 2 months
24 hour mean systolic Blood Pressure (SBP) Control
Ambulatory Blood pressure monitoring at the end of intervention will be used to assess 24 hour ( day and nighttime) blood pressure control We hypothesize that night time dosing of medication ( chronotherapy) will not only improve nocturnal hypertension but also improve awake blood pressure and overall 24 hour average SBP control.
Time frame: 2 months
This study is withdrawn, as verified in May 2013. You cannot join it, but the record below documents what was studied.
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Northwell Health