Selected Ongoing Clinical Trials (*). (Featured CME Topic: Hypertension).

* PREMIER: LIFESTYLE INTERVENTIONS FOR BLOOD PRESSURE CONTROL.

This Phase III, multicenter study will compare the effectiveness of advice versus two multi-component lifestyle interventions to control blood pressure in individuals with stage 1 hypertension or higher than optimal blood pressure. Both men and women aged 25 years and older with mildly elevated blood pressure are eligible.

* INSULIN ACTION: ROLE OF SKELETAL MUSCLE AND INSULIN-MEDIATED BLOOD FLOW

This Phase I, natural history study will examine the contribution of changes in total body fat, enhancement in insulin-mediated vasodilatation, and enhancement in endothelium-derived nitric oxide production to the improvements in metabolic insulin action. It will also determine whether these improvements are related to changes in blood pressure. Both men and women aged 50 to 75 years with elevated blood pressure are eligible.

* HYPERTENSION SCREENING AND TREATMENT PROGRAM.

This longitudinal, prospective study will examine how much mortality is affected by visit compliance, blood pressure control and type of antihypertensive agents. It will also seek to identify inexpensive regimens that are as effective as more expensive ones. The data will be used to treat veterans with hypertension. US male Veterans aged 18 years and older who are patients of hypertension screening and treatment program clinics are eligible.

* TREATMENT OF HYPERTENSION WITH TWO EXERCISE INTENSITIES.

This Phase III study will determine whether exercise training can significantly replace medication as a treatment for mild essential hypertension. Both men and women aged 18 to 75 years with mild essential hypertension are eligible.

* EFFECT OF INSULIN RESISTANCE ON BLOOD VESSEL TONE IN NORMAL VOLUNTEERS, PATIENTS WITH HIGH BLOOD PRESSURE, AND PATIENTS WITH HIGH CHOLESTEROL.

This natural history study will determine if insulin resistance is associated with increased blood vessel endothelin activity in patients with high blood pressure and high cholesterol. It will also determine if high levels of insulin associated with insulin resistance stimulates nitric oxide in normal volunteers and patients with high blood pressure and high cholesterol. Both men and women with blood pressure greater than or equal to 145/94 mm/Hg on at least three separate days are eligible.

* MAGNETIC RESONANCE IMAGING FOR EVALUATING KIDNEY FUNCTION.

This natural history study will evaluate the usefulness of magnetic resonance imaging as a tool for diagnosing renovascular hypertension. Both men and women who are healthy volunteers or have significant clinical suspicion of renovascular hypertension are eligible.

* EFFECTS OF ENDOTHELIN RECEPTOR BLOCKADE ON ENDOTHELIUM-DEPENDENT VASODILATOR FUNCTION IN PATIENTS WITH HIGH BLOOD PRESSURE.

This natural history study is designed to help researchers understand one of the possible ways that high blood pressure can cause damage to blood vessels and cause hardening of arteries. Men and nonpregnant women with essential hypertension are eligible.

* POTENTIAL RISK FACTORS FOR STROKE.

This Phase I, clinical trial will attempt to characterize factors that may contribute to atherosclerosis and stroke by measuring certain components of the immune system. Both men and women 18 years old and older who have documented hypertension are eligible.

(*) Additional clinical trials are listed in the September 2001 issue of the Southern Medical Journal, CME Featured Topic: Issues in Primary Care, and in the October 2001 issue, CME Featured Topic: The Older Patient.

(*.)Prepared by Elaine McClellan-Holm.