UAB researchers analyze the role that natriuretic peptides play in high nighttime blood pressure.According to the Centers for Disease Control and Prevention, high blood pressure was a primary or contributing cause of more than a half million deaths in the United States in 2019. Researchers at the University of Alabama at Birmingham have launched a study in a subset of patients — obese individuals who experience high blood pressure at nighttime.
Pankaj Arora, M.D., an associate professor in the UAB Heersink School of Medicine Division of Cardiovascular Disease, was awarded a $3.7 million grant from the National Heart, Lung, and Blood Institute to study whether increasing natriuretic peptide levels using FDA-approved drugs at nighttime will help improve the nighttime blood pressure in obese individuals.
Obese individuals with high blood pressure at nighttime have an increased risk of a fatal cardiac event even if their daytime blood pressure is normal. With nearly half of the population in the United States expected to be obese by 2030, the risk of heart attack or stroke from high nighttime blood pressure is expected to climb drastically. Scientists believe that the 24-hour rhythm of heart hormones called natriuretic peptides may play a role in this increase in nighttime blood pressure.
Arora’s past research has shown that obese individuals can have up to 40 percent lower levels of beneficial natriuretic peptides throughout a 24-hour period. Now, Arora and other researchers are studying whether high nighttime blood pressure can be better managed by prescribing medication that increases levels of natriuretic peptides and by changing the time of day people take these medications.
From left to right, Vibhu Parcha, M.D., and Pankaj Arora, M.D.,“We envision that, through this clinical trial, we will be able to advance the needle of scientific evidence supporting the use of precision medicine in management of high blood pressure,” said Arora, the principal investigator of the study and director of the Cardiovascular Clinical and Translational Research Program and the UAB Cardiogenomics Clinic. “We are moving beyond simply giving standard treatment across the board that may or may not work for everyone. This support from the NHLBI allows us to understand whether we can truly help people by using robust science to guide their medical therapy. Through this research, we hope to use a patient’s biological profile to identify which medication a patient should take, the amount they should take and the time of day they should take it.”
Arora believes that being precise in the approach of treatment will saves billions of dollars downstream in terms of multiple hospital and clinic visits, medications, and lab tests. The clinical study for this research is open for enrollment and can be found by visiting clinicaltrials.gov under the name the PRECISION-BP study. Those interested in enrolling in the trial should email PRECISION-BPSTUDY@uabmc.edu to set up an appointment.
The UAB Cardiovascular Institute has been advancing the initiative for the inclusion of underrepresented individuals in clinical research to help improve the understanding of what drives the development of diabetes in the community through the UAB Cardiovascular Research Biobank effort. There are several such initiatives being led by UAB physician-scientists to enhance the participation of underrepresented communities in medical research. UAB Cardiovascular Institute helps provide patients with a comprehensive cardiovascular and metabolic assessment and provide the latest efficacious cardiovascular and metabolic diagnostics and therapeutics for common conditions such as hypertension, diabetes mellitus, heart attacks, heart failure, stroke and valvular heart disease, and diseases of blood vessels.