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Defining Strategies for Improving Endothelial and Fibrinolytic Dysfunction in Obesity

This study has been terminated.
(Lack of enrollment)
Information provided by (Responsible Party):
James Muldowney, Vanderbilt University Identifier:
First received: January 22, 2008
Last updated: July 13, 2017
Last verified: July 2017
The combination of high blood pressure and having central obesity is an increasing important factor for heart disease in men and women. It can also lead to the early development of hardening of the arteries and increased risk of a stroke. This study will analyze patients' genetic make up to identify who may be at greater risk for heart disease and strokes in relationship to high blood pressure and central obesity.

Condition Intervention Phase
Metabolic Syndrome X Drug: Eplerenone Drug: Ramipril Phase 4

Study Type: Interventional
Study Design: Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Double (Participant, Investigator)
Primary Purpose: Prevention
Official Title: Defining Strategies for Improving Endothelial and Fibrinolytic Dysfunction in Obesity

Resource links provided by NLM:

Further study details as provided by James Muldowney, Vanderbilt University:

Primary Outcome Measures:
  • Secreted Factors From Adipocytes Have Autocrine, Paracrine and Endocrine Effects That Have a Deleterious Effect on the Fibrinolytic System, Either by Enhancing PAI-1 Production or Impairing Endothelial t-PA Release [ Time Frame: 10-Week period ]
  • This Study Will Analyze Patients' Genetic Make up to Identify Who May be at Greater Risk for Heart Disease and Strokes in Relationship to High Blood Pressure and Central Obesity. [ Time Frame: 10-weeks ]

Enrollment: 4
Actual Study Start Date: May 2006
Study Completion Date: May 2011
Primary Completion Date: May 2009 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Active Comparator: Treatment A
Eplerenone (study drug)
Drug: Eplerenone
5 mg x 1 week followed by 10 mg x 9 weeks.
Other Name: Inspra
Active Comparator: Treatment B
Drug: Ramipril
Ramipril 5mg qd x 1 week f/b Ramipril qd x 9 weeks.

Detailed Description:
Obesity is an increasingly important risk factor for cardiovascular disease in men and women and is associated with the premature development of atherosclerosis, and increased risk of stroke. A classical perspective of cardiovascular risk does not adequately explain all of the cardiovascular events associated with obesity. Elevated plasma levels of plasminogen activator inhibitor type I (PAI-1) are one of the biochemical hallmarks for obesity and likely contribute the increased risk of atherothrombotic events in patients with obesity. The central hypothesis of this proposal is that the increased risk of atherothrombotic events in patients with obesity. The central hypothesis of this proposal is that vascular PAI-1 excess promotes the development of intravascular thrombosis. We will test the hypothesis that secreted factors from adipocytes have autocrine, paracrine and endocrine effects that have a deleterious effect on the fibrinolytic system, either by enhancing PAI-1 production or impairing endothelial t-PA release. From a public health perspective, there is no greater threat to America's cardiovascular health than the epidemic of obesity. It is anticipated that this study will provide new insights nto the molecular mechanisms that contribute to the development of fibrinolytic dysfunction and cardiovascular disease in obesity.

Ages Eligible for Study:   18 Years and older   (Adult, Senior)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   Yes

Inclusion Criteria:

  • Male or females between the ages of 18 to 65 years of age.
  • Documented diagnosis for the metabolic syndrome:
  • Subjects with hypertension (SP>130mmHg)
  • Subjects with central obesity (females waist >35"; males waist >40")
  • Subjects with dyslipidemia (HDL <40mg/dl, triglycerides > 150 mg/dl)
  • Subjects who are insulin resistance (fasting glucose >100mg/dl)

Exclusion Criteria:

  • Subjects who smoke
  • Women who are pregnant (confirmed by urine beta-HCG).
  • Women who are breast feeding
  • Subjects with documentation of the following health risk:

    • Subjects with serum creatinine >2.0 mg/dl (males), >1.8 mg/dl (females)
    • Subjects whose creatinine clearance < 50 mls/min
    • Subjects with serum potassium >5.5mEql
    • Subjects with Type 2 diabetes with microalbuminuria (spot urine protein/creatinine ration >0.2)
  • Subjects who are currently taking the following medications:
  • Warfarin
  Contacts and Locations
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below. For general information, see Learn About Clinical Studies.

Please refer to this study by its identifier: NCT00608465

United States, Tennessee
Vanderbilt University Medical Center
Nashville, Tennessee, United States, 37232
Sponsors and Collaborators
Vanderbilt University
Principal Investigator: James AS Muldowney, MD Vanderbilt University Medical Center
  More Information

Responsible Party: James Muldowney, Assistant Professor of Medicine, Vanderbilt University Identifier: NCT00608465     History of Changes
Other Study ID Numbers: 060369
Study First Received: January 22, 2008
Results First Received: March 16, 2017
Last Updated: July 13, 2017

Keywords provided by James Muldowney, Vanderbilt University:
Fibrolytic Dysfunction

Additional relevant MeSH terms:
Metabolic Syndrome X
Nutrition Disorders
Body Weight
Signs and Symptoms
Insulin Resistance
Glucose Metabolism Disorders
Metabolic Diseases
Angiotensin-Converting Enzyme Inhibitors
Protease Inhibitors
Enzyme Inhibitors
Molecular Mechanisms of Pharmacological Action
Antihypertensive Agents
Mineralocorticoid Receptor Antagonists
Hormone Antagonists
Hormones, Hormone Substitutes, and Hormone Antagonists
Physiological Effects of Drugs
Diuretics, Potassium Sparing
Natriuretic Agents processed this record on September 21, 2017