HaemoDYNAMICs in Primary and Secondary Hypertension

  • End date
    Dec 31, 2025
  • participants needed
  • sponsor
    Tampere University
Updated on 28 August 2021
aortic stenosis


The primary aim of the present study was to examine the haemodynamic changes in primary hypertension and secondary hypertension (renal diseases, endocrine diseases, obesity-associated hypertension) with a non-invasive haemodynamic measurement protocol utilizing radial pulse wave analysis and whole-body impedance cardiography in both supine position and during head-up tilt. For comparison, haemodynamics of subjects with chronic fatigue syndrome will also be recorded.


Elevated blood pressure (BP) and related cardiovascular complications are the leading causes of morbidity and mortality in the modern world. In routine clinical practice, the haemodynamic status is commonly assessed by measuring heart rate and blood pressure at rest, which provides only limited information about functional haemodynamic status. In addition, the haemodynamic changes resulting in similar elevations of BP may differ substantially between patients and disorders.

Therefore, we investigated the haemodynamic changes in primary and secondary hypertension and in the control subjects with non-invasive radial pulse wave analysis and whole-body impedance cardiography. The method includes the determination of volume status using bioimpedance spectroscopy, determination of peripheral and central BP, cardiac function, vascular resistance, arterial compliance and indices of pulse wave reflection. Besides the measurements performed in the supine position, passive orthostatic challenge is included in the protocol to assess the upright functional haemodynamic status.

The repeatability and reproducibility of the protocol was first examined with a double-blind, randomized protocol in 35 subjects (methodological study group), and after that the administration of research drugs has been open-label. The effects of single doses of two largely endothelium-dependent agents, inhaled salbutamol and intravenous L-arginine, and one endothelium-independent agent, sublingual nitroglycerin, were investigated. However, challenges with the acute dosing of all medical compounds was terminated at the end of December 2016. Thereafter, the measurement protocol has included supine and upright recordings on the tilt-table, followed by supine measurements during paced breathing (15 breaths per minute for 5 minutes, 6 breaths per minute for 5 minutes) that modulate the autonomic nervous tone.

The study population has consisted of subgroups described below. The study protocol of each subgroup has been approved by the ethics committee of the Pirkanmaa Hospital District (Ethics committee ID's above), and the administration of research drugs has also been approved by the Finnish Agency for Medicines (EudraCT-numbers above).

Condition kidney insufficiency, Kidney Failure (Pediatric), Renal Dysfunction, aortic valve stenosis, Aortic Stenosis, Primary Hypertension, renal insufficiency, Kidney Disease, Impaired Renal Function, Nephropathy, Kidney Failure, Kidney Disease (Pediatric), Essential Hypertension, Renal Failure, VALVULAR HEART DISEASE, Renal Impairment, Secondary Hypertension, Heart Valve Disease
Treatment Nitroglycerin 0.25 mg (single dose), Salbutamol 400 µg (single dose), L-arginine (10 min infusion), Liquorice (2 weeks, glycyrrhizin 290-370 mg daily), Small milk casein-derived polypeptides (12 weeks daily), Bisoprolol (5mg daily for 3 weeks), Nitroglycerin 0.25 mg (single dose, no longer given since January 2017), Salbutamol 400 µg (single dose, no longer given since January 2017), L-arginine (10 min infusion, no longer given since January 2017), Liquorice (2 weeks, glycyrrhizin 290-370 mg daily, no longer given since 2012), Small milk casein-derived polypeptides (12 weeks daily, recordings completed 2011), Bisoprolol (5 mg daily for 3 weeks, recordings completed 2011)
Clinical Study IdentifierNCT01742702
SponsorTampere University
Last Modified on28 August 2021


Yes No Not Sure

Inclusion Criteria

Independent, community-dwelling adults
Hypertensive subjects (primary or secondary hypertension)
Normotensive control subjects
Subjects with aortic stenosis (subgroup "aortic stenosis")
Participants of Ironman Triathlon competition

Exclusion Criteria

Systolic blood pressure <90 mmHg
Allergies to test compounds
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