Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
The pathophysiology of malignant hypertension is poorly understood. The objective of this translational research project is to evaluate the relationship between activation of vasoactive systems (renin-angiotensin and endothelin systems), angiogenic signal deficiency (VEGF and sFlt-1) and the occurrence of malignant hypertension episodes in humans.
The pathophysiology of malignant hypertension is poorly understood. The current dogma is based on an overwhelming renin-angiotensin-aldosterone system activation, leading to arterial hypertension that overcomes target organ auto-regulatory mechanisms and leads to subacute microvascular lesions. However, some patients present with normal or lowered renin in the acute phase of malignant hypertension, suggesting other pathophysiological pathways. Malignant hypertension was reported following anti-VEGF treatment, suggesting that this pathway may be involved. Recent unpublished animal data highlight 1/ the possibility of severe deregulation of the VEGF (vascular endothelial growth factor) system in malignant hypertension 2/ the possibility of compensation of the vasculotoxic effects of VEGF deficiency by inflammasome components. These systems have never been studied together in human hypertension.
Investigators will analyze the angiogenic, vasoactive and VEGF systems through blood and urine sampling. These samples will be collected at the time of malignant hypertension diagnosis and repeated one month later in 30 patients. The same tests will be performed in 15 patients with severe non-malignant hypertension, constituting the control group.
Not provided
Not provided
Not provided
Not provided
Not provided
| Label | Type | Description | Intervention Names |
|---|---|---|---|
| patients group | patients with malignant hypertension |
| |
| Control group | patients with severe hypertension (Grade 2 or 3 hypertension) |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| analyse of angiogenic, vasoactive and VEGF systems | Biological | the angiogenic, vasoactive and VEGF systems will be analysed through blood and urine sampling. These samples will be collected at the time of malignant hypertension diagnosis and repeated one month later, in 30 patients (patients group). The same tests will be performed once in 15 patients with severe non-malignant hypertension, constituting the control group. |
| Measure | Description | Time Frame |
|---|---|---|
| sFLT1 concentration at inclusion | The primary endpoint will be the difference in sFLT1 concentrations between patients and controls at enrolment | at the end of study recrutment, an average of 11 month |
| Measure | Description | Time Frame |
|---|---|---|
| IL1ß concentration at inclusion | Difference in IL1ß concentrations between patients and controls at enrolment | at the end of study recrutment, an average of 11 month |
| VEGF concentration at inclusion |
Not provided
Inclusion Criteria:
Patients group :
Control group :
Exclusion criteria:
Patients group :
Control group:
Not provided
Not provided
Not provided
patient group: patient with malignant hypertension control group: paitent with severe hypertension
Not provided
Not provided
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Hôpital Avicenne | Bobigny | France | ||||
| CHU de Bordeaux |
Not provided
| ID | Term |
|---|---|
| D006974 | Hypertension, Malignant |
| D006973 | Hypertension |
| D000096003 | Hypertensive Crisis |
| ID | Term |
|---|---|
| D014652 | Vascular Diseases |
| D002318 | Cardiovascular Diseases |
Not provided
Not provided
Not provided
Not provided
Not provided
Blood samples
|
Difference in VEGF concentrations between patients and controls at enrolment
| at the end of study recrutment, an average of 11 month |
| renin concentration at inclusion | Difference in renin concentrations between patients and controls at enrolmentD30, and compare this evolution. | at the end of study recrutment, an average of 11 month |
| angiotensin concentration at inclusion | Difference in angiotensin concentrations between patients and controls at enrolmentD30, and compare this evolution. | at the end of study recrutment, an average of 11 month |
| evolution of IL1ß concentration | Evaluation of the evolution of IL1ß concentration in the two groups between D0 and D30, and compare this evolution. | through study completion, an average of 12 month |
| evolution of VEGF concentration | Evaluation of the evolution of VEGF concentration in the two groups between D0 and D30, and compare this evolution. | through study completion, an average of 12 month |
| evolution of renin concentration | Evaluation of the evolution of renin concentration in the two groups between D0 and D30, and compare this evolution. | through study completion, an average of 12 month |
| evolution of angiotensin concentration | Evaluation of the evolution of angiotensin concentration in the two groups between D0 and D30, and compare this evolution. | through study completion, an average of 12 month |
| mutations in the genes of interest | comparison in the 2 groups of the frequency of mutations in the genes of interest underlying the vasoactive, angiogenic and VEGF systems | through study completion, an average of 11 month |
| Bordeaux |
| France |
| Hôpital Bichat | Paris | France |
| Hôpital Européen Georges Pompidou | Paris | France |
| Hôpital Tenon | Paris | France |
| Chu Rangueil | Toulouse | France |
| CHU de Tours | Tours | France |