Perirenal Adipose Tissue Modification Therapy for Resistant Hypertension
For patients and families
In plain language
An automatic summary of structured registry data. It is an orientation aid, not a substitute for the official protocol or a physician assessment.
- What is being studied
- The protocol lists: Perirenal adipose tissue modification by focused power ultrasound, Sham.
- Who it may be relevant to
- Registry conditions: Resistant Hypertension. Basic parameters: 18 years — 75 years · All.
- What needs checking
- Age, condition and sex are only basic indicators. Prior treatment, laboratory values and other mandatory requirements appear in the eligibility criteria below.
- Where it takes place
- China
- Next step
- Save the trial, show it to the treating physician, and confirm current recruitment with the study center. Costs, documents and travel →
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Official title
The Efficacy and Safety of Perirenal Adipose Tissue Modification Therapy by Focused Power Ultrasound for Resistant Hypertension
Overview
The goal of this clinical trial is to investigate if focused power ultrasound (FPU) targeted perirenal adipose tissue modification therapy would be effective and safe in treating resistant hypertension. The primary outcome of the study is the difference in the reduction of 24h mean systolic blood pressure between treatment and sham procedure groups 6 months after treatment. The secondary outcomes include the reduction of clinic blood pressure 1, 3, and 6 months after treatment, the reduction of 24h mean blood pressure 1, 3, and 6 months after treatment, and the drug burden of antihypertensive treatment. The safety evaluation includes the incidence of all-cause death, cardiovascular events (stroke and myocardial infarction), renal failure, and other adverse events.
Detailed description
Hypertension is the most common cardiovascular disease. However, the control rate of hypertension in China is very low. Resistant hypertension is defined as uncontrolled blood pressure despite optimal lifestyle modifications and the use of three appropriately tolerated, maximally dosed antihypertensive drugs (including a diuretic), or controlled blood pressure with four antihypertensive drugs. Resistant hypertension is associated with increased cardiovascular risk and poor prognosis.
Previous studies have shown that bilateral perirenal adipose tissue (PRAT) ablation or denervation leads to a long-term blood pressure reduction in spontaneous hypertensive rats. Focused power ultrasound (FPU) targeted PRAT modification therapy is a novel intervention aiming to physically or chemically modify PRAT using ultrasound energy, remove nerve fibers, and treat hypertension. Preliminary feasibility and safety was proved in a pilot study of 20 patients. However, a larger, randomized trial is needed to prove efficacy and long-term safety of the treatment.
Participants with resistant hypertension will be recruited in 10 centers and then to investigate whether PRAT modification therapy by FPU is effective and safe for patients with resistant hypertension.
Interventions
- Procedure Perirenal adipose tissue modification by focused power ultrasound
Perirenal adipose tissue modification by focused power ultrasound at both kidneys - Procedure Sham
Sham procedure of focused ultrasound at both kidneys
Primary outcome measures
- Reduction in 24h systolic blood pressure at the 6-month after treatment [Time frame: 6 months after treatment]
Secondary outcome measures (7)
- Reduction in 24h ambulatory systolic/diastolic blood pressure [Time frame: 1 month after treatment]
- Reductions in 24h ambulatory systolic/diastolic blood pressure [Time frame: 3 months after treatment]
- Reduction in 24h ambulatory diastolic blood pressure [Time frame: 6 months after treatment]
- Reduction in clinic systolic/diastolic blood pressure [Time frame: 1 month after treatment]
- Reduction in clinic systolic/diastolic blood pressure [Time frame: 3 months after treatment]
- Reduction in clinic systolic/diastolic blood pressure [Time frame: 6 months after treatment]
- Drug burden of antihypertensive treatment [Time frame: 6 months after the treatment]
Eligibility criteria
Inclusion criteria
- Male or female participants aged 18-75 years old;
- 24h ambulatory systolic BP ≥130mmHg and <150mmHg, and 24h ambulatory diastolic BP <100mmHg after at least 4 weeks of combined treatment with 3 antihypertensive drugs (including a diuretic);
- The ultrasound measured inferior perirenal adipose tissue ≥8 cm3 (with the superior-inferior diameter, left-right diameter, and anterior-posterior diameter all needing to be ≥20 mm);
- Be willing to participate in the trial, and be able to visit doctors by himself or herself;
- Sign the informed consent form.
Exclusion criteria
- Secondary hypertension;
- Occurrence of myocardial infarction, malignant arrhythmia, severe renal failure, or stroke within 6 months;
- Ambulatory BP monitoring was invalid (<70% valid readings, or <20 daytime readings or <7 nighttime readings);
- Alanine transaminase (ALT), aspartate transaminase (AST), or total bilirubin (TBL) above twice the normal range; eGFR (CKD-EPI) <45mL/min/1.73m2;
- Type 1 diabetes mellitus or uncontrolled Type 2 diabetes mellitus (glycated hemoglobin ≥8.5%);
- Single functionally normal kidney or presence of renal malignant tumor;
- Bilateral skin diseases at renal region that are not suitable for the therapy;
- Women in pregnancy, lactating, or planning for pregnancy;
- Other concomitant diseases that are considered not suitable for participation in the trial;
- Patients have contraindications to angiotensin receptor-neprilysin inhibitor (ARNIs), thiazide-like diuretic drugs, or calcium channel blocker (CCBs);
- Non-compliant patients.
Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.
Healthy volunteers: No
Study design
- Allocation
- Randomized
- Model
- Parallel assignment
- Masking
- Double blind
- Primary purpose
- Treatment
Study locations
China · 1 center
- Ruijin Hospital — Shanghai
Identifiers
NCT: NCT07232966 · 2025148