Influence of altitude on hypertension phenotypes and responses to antihypertensive therapy: Review of the literature and design of the INTERVENCION trial

Josefina Medina-Lezama; Karela Herrera-Enriquez; Offdan Narvaez-Guerra; Julio A Chirinos

doi:10.1111/jch.13932

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Influence of altitude on hypertension phenotypes and responses to antihypertensive therapy: Review of the literature and design of the INTERVENCION trial

Journal article

Peer reviewed

Influence of altitude on hypertension phenotypes and responses to antihypertensive therapy: Review of the literature and design of the INTERVENCION trial

Josefina Medina-Lezama, Karela Herrera-Enriquez, Offdan Narvaez-Guerra and Julio A Chirinos

The journal of clinical hypertension (Greenwich, Conn.), Vol.22(10), pp.1757-1762

10/2020

DOI: 10.1111/jch.13932

PMCID: PMC8029791

PMID: 32941700

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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.

Adult

Altitude

Angiotensin Receptor Antagonists - therapeutic use

Antihypertensive Agents - therapeutic use

Blood Pressure - drug effects

Blood Pressure Monitoring, Ambulatory

Calcium Channel Blockers - therapeutic use

Diuretics - therapeutic use

Humans

Hypertension - drug therapy

Phenotype

Randomized Controlled Trials as Topic

Details

Title: Subtitle: Influence of altitude on hypertension phenotypes and responses to antihypertensive therapy: Review of the literature and design of the INTERVENCION trial
Creators: Josefina Medina-Lezama - Catholic University of Santa María
Karela Herrera-Enriquez - Sinai Hospital
Offdan Narvaez-Guerra - University of Connecticut
Julio A Chirinos - Hospital of the University of Pennsylvania
Resource Type: Journal article
Publication Details: The journal of clinical hypertension (Greenwich, Conn.), Vol.22(10), pp.1757-1762
DOI: 10.1111/jch.13932
PMID: 32941700
PMCID: PMC8029791
NLM abbreviation: J Clin Hypertens (Greenwich)
ISSN: 1524-6175
eISSN: 1751-7176
Grant note: R01 HL121510 / NHLBI NIH HHS R56 HL136730 / NHLBI NIH HHS R03 HL146874 / NHLBI NIH HHS R01 HL104106 / NHLBI NIH HHS R01 AG058969 / NIA NIH HHS P01 HL094307 / NHLBI NIH HHS R61 HL146390 / NHLBI NIH HHS
Language: English
Date published: 10/2020
Academic Unit: Internal Medicine
Record Identifier: 9984845468402771

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