Pediatric Hypertension and the Renin-Angiotensin SystEm (PHRASE)

Description

Studying the causal roles of components of the renin-angiotensin-aldosterone system (including angiotensin-(1-7) (Ang-(1-7)), angiotensin-converting enzyme 2 (ACE2), Ang II, and ACE), uric acid, and klotho in pediatric hypertension and related target organ injury, including in the heart, kidneys, vasculature, and brain. Recruiting children with a new hypertension diagnosis over a 2-year period from the Hypertension and Pediatric Nephrology Clinics affiliated with Brenner Children's Hospital at Atrium Health Wake Forest Baptist and Atrium Health Levine Children's Hospital. Healthy control participants will be recruited from local general primary care practices. Collecting blood and urine samples to analyze components of the renin-angiotensin-aldosterone system (Ang-(1-7), ACE2, Ang II, ACE), uric acid, and klotho, and measuring blood pressure, heart structure and function, autonomic function, vascular function, and kidney function at baseline, year 1, and year 2. Objectives are to investigate phenotypic and treatment response variability and to causally infer if Ang-(1-7), ACE2, Ang II, ACE, uric acid, and klotho contribute to target organ injury due to hypertension.

Conditions

Hypertension, Left Ventricular Hypertrophy, Left Ventricular Dysfunction, Left Atrial Dilatation, Left Ventricular Diastolic Dysfunction, Kidney Diseases, Kidney Injury, Kidney Dysfunction, Sodium Urine High, Blood Pressure Disorders, Uric Acid Retention, Angiotensin Hypertension, Autonomic Dysfunction, Autonomic Imbalance, Pediatric Kidney Disease, Pediatric Obesity, Proteinuria, Albuminuria

Study Overview

Study Details

Study overview

Studying the causal roles of components of the renin-angiotensin-aldosterone system (including angiotensin-(1-7) (Ang-(1-7)), angiotensin-converting enzyme 2 (ACE2), Ang II, and ACE), uric acid, and klotho in pediatric hypertension and related target organ injury, including in the heart, kidneys, vasculature, and brain. Recruiting children with a new hypertension diagnosis over a 2-year period from the Hypertension and Pediatric Nephrology Clinics affiliated with Brenner Children's Hospital at Atrium Health Wake Forest Baptist and Atrium Health Levine Children's Hospital. Healthy control participants will be recruited from local general primary care practices. Collecting blood and urine samples to analyze components of the renin-angiotensin-aldosterone system (Ang-(1-7), ACE2, Ang II, ACE), uric acid, and klotho, and measuring blood pressure, heart structure and function, autonomic function, vascular function, and kidney function at baseline, year 1, and year 2. Objectives are to investigate phenotypic and treatment response variability and to causally infer if Ang-(1-7), ACE2, Ang II, ACE, uric acid, and klotho contribute to target organ injury due to hypertension.

Pediatric Hypertension and the Renin-Angiotensin SystEm (PHRASE): The Role of Angiotensin-(1-7) in Hypertension and Hypertension-Induced Heart and Kidney Damage

Pediatric Hypertension and the Renin-Angiotensin SystEm (PHRASE)

Condition
Hypertension
Intervention / Treatment

-

Contacts and Locations

Winston-Salem

Wake Forest Health Sciences, Winston-Salem, North Carolina, United States, 27157

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

For general information about clinical research, read Learn About Studies.

Eligibility Criteria

  • * 7-18 years of age at time of enrollment
  • * Confirmed new diagnosis of primary hypertension: no identifiable secondary cause, referred to hypertension or nephrology clinic
  • * Age \<13 years: BP ≥95th %ile or ≥130/80 mmHg (whichever is lower)
  • * Age ≥13 years: BP ≥130/80 mmHg
  • * Participants and their caregivers must be willing and able to commit to completing the study assessments
  • * \<7 years or \>18 years of age at time of enrollment
  • * BP confirmed as normal or in the elevated BP category based on ≥3 prior office BP measurements on separate days;
  • * Age \<13 years: BP \<95th %ile or \<130/80 mmHg (whichever is lower)
  • * Age ≥13 years: BP \<130/80 mmHg
  • * A confirmed secondary cause of hypertension
  • * Confounding medical condition (heart or kidney disease \[except hypertension-associated heart changes on echocardiogram or albuminuria\], vascular/inflammatory disease, or diabetes)
  • * Inability to complete study assessments
  • * Non-English/Spanish speakers
  • * Current pregnancy
  • * Ward of the State

Ages Eligible for Study

7 Years to 18 Years

Sexes Eligible for Study

ALL

Accepts Healthy Volunteers

Yes

Collaborators and Investigators

Wake Forest University Health Sciences,

Andrew M South, MD, MS, PRINCIPAL_INVESTIGATOR, Wake Forest Health Sciences

Study Record Dates

2025-12