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Role of Mineralocorticoid Receptor in Diabetic Cardiovascular Disease

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City:   Boston
State:   Massachusetts
Zip Code:   02115
Conditions:   Type 2 Diabetes Mellitus - Vascular Disease
Purpose:   Aldosterone is a significant mediator of cardiovascular injury associated with heart failure and the cardiovascular benefits of mineralocorticoid receptor blockade are additive to those of angiotensin converting enzyme inhibitors or angiotensin II receptor blockers. This study will test the hypothesis that MR antagonists exert beneficial cardiovascular effects, specifically by decreasing vascular injury and improving vascular function.A randomized, double-blind study will be conducted, in which subjects with Type 2 Diabetes Mellitus will undergo a series of assessments to test heart, blood vessel, and kidney function at baseline, and after 2 and 6 months of treatment with one of the following drugs: 1. spironolactone 2. hydrochlorothiazide plus potassium 3. placebo. In the event of insufficient funds, randomization to the placebo arm will be stopped and primary assessment of outcomes will occur at baseline and after 6 months of treatment.
Study Summary:  
Criteria:   Inclusion Criteria: - age 18-70 years - type 2 diabetes mellitus - with or without hypertension Exclusion Criteria: - ischemic changes on resting electrocardiogram, - clinical evidence of heart disease (angina, heart failure, unstable angina),cerebrovascular or peripheral vascular disease, - significant cardiac arrhythmias, - aortic stenosis, - 2nd or 3rd degree atrio-ventricular block, sinus node disease, or symptomatic bradycardia, - bronchospastic lung disease with active wheezing, - known hypersensitivity to adenosine, - hemoglobin A1C > 8.5%, * - gout (If not already taking HCTZ), - the use of Rosiglitazone,** - eGFR < 60 ml/min, - serum potassium > 5.0 mmol/L, - use of potassium-sparing diuretics,** - current smoker,* - pregnancy, - renal disease not related to diabetes mellitus, - uncontrolled hypertension, systolic BP >160 mm Hg and diastolic BP >100 mm Hg,* - use of cyclic hormone replacement therapy - past intolerance of ACE inhibitor therapy - other major medical illnesses. Subjects with evidence of a previous myocardial infarction on the first adenosine-stimulated PET study will be withdrawn from the study. - Screening systolic blood pressure < 105 mm Hg off of anti-hypertensive medications - Subjects can enroll in study and proceed with in-patient evaluations if during the run-in period adjustments of medications, diet and habits lead to improved glucose control (equivalent to HbA1c <8.5%), controlled hypertension and cessation of smoking. - Subjects who are currently taking these medications will not qualify for a screening visit. If medications were recently stopped by the subject's physician, he or she may be screened but the baseline assessment protocol must occur 3 months after stopping.
NCT ID:   NCT00865124
Primary Contact:   Principal Investigator
Gail K Adler, MD, PhD
Brigham and Women's Hospital

Backup Contact:   N/A
Location Contact:   Boston, Massachusetts 02115
United States



There is no listed contact information for this specific location.

Site Status: N/A

Data Source:   ClinicalTrials.gov
Date Processed:   June 18, 2013
Modifications to this listing:   Only selected fields are shown, please use the link below to view all information about this clinical trial.
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