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Hypertension and LVH Study with Eplerenone or Chlorthalidone

This study is for people aged 18 to 75 with high blood pressure (hypertension) and a thickened heart muscle (left ventricular hypertrophy or LVH). Researchers want to see if eplerenone, a mineralocorticoid receptor (MR) antagonist, or chlorthalidone, a diuretic, can improve how well your heart's small blood vessels work and how efficiently your heart pumps blood. You would first be transitioned to enalapril, another blood pressure medication, and then randomly assigned to receive either eplerenone or chlorthalidone plus potassium for 9 months. The main goal is to measure changes in your heart's blood flow reserve after 9 months. This study aims to find out if these treatments can also improve your heart's structure and function. The current recruitment status is unclear.

Study design
This is an interventional study planning to enroll 75 participants. Participants will be randomly assigned to one of two treatment groups.
What's involved
You would take study medication (enalapril, then either eplerenone or chlorthalidone + potassium) for 9 months. Your medication dosage may be adjusted at 2 weeks. You will have assessments, including cardiac PET scans and echocardiograms.
Compensation
Not stated in the trial record.
Follow-up
The primary outcome is measured at 9 months, indicating the duration of the treatment period.

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NCT05593055

Mineralocorticoid Receptor, Coronary Microvascular Function, and Cardiac Efficiency in Hypertension

Recruiting
PHASE4Ages 18–75InterventionalBasic science
Brigham and Women's Hospital
~75 participants
Updated 2026-04-06 on ClinicalTrials.gov
What's tested:EplerenoneChlorthalidonePotassium

At a glance

Recruiting sites
1 of 1 listed site is recruiting right now
RecruitingSuspended, closed, or not yet open
What they're measuring
Change in myocardial flow reserve
Measured over 9 months

Conditions

Hypertension
Left Ventricular Hypertrophy

Explore related trials

HypertensionLeft Ventricular Hypertrophy

Where it's being run

1 sites across 1 states
Massachusetts1

Study leadership

  • Gail K Adler, MD, PhD · PRINCIPAL_INVESTIGATOR · Brigham and Women's Hospital

Who to contact

Gail K Adler, MD, PhD
[email protected]
781-223-2686
Email the study team

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Do you actually qualify for this trial?

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Eligibility criteria

Exclusion

Use of MR antagonist (eplerenone, spironolactone, or finerenone) or amiloride (amiloride inhibits ENaC, which is a key mediator of MR's actions) within the past year
Orthostatic hypotension
Major medical illness, including uncontrolled diabetes mellitus (Hemoglobin A1c \>7.5)
LV ejection fraction \< 40%
New York Heart Association class III to IV congestive heart failure or unstable angina
A history in the prior 6 months of Q-wave myocardial infarction, stroke, transient ischemic attack, percutaneous transluminal coronary angioplasty, or coronary artery bypass graft
History of secondary hypertension
Known genetic cardiomyopathy
Renal disease (seum creatinine \>1.5 mg/dL for men and \>1.3 mg/dL for women)
Hepatic disease
Bronchospastic lung disease
Alcohol or substance abuse
Hormone replacement therapy
Abnormal values for electrolytes, liver enzymes or TSH
Pregnancy or lactation
All individuals \<18 and \>75 years will be excluded due to safety concerns of administering an angiotensin-II infusion in these patient groups.

What this trial measures

  • Change in myocardial flow reserve9 months

    Change in myocardial flow reserve (ratio of hyperemic stress myocardial blood flow to rest myocardial blood flow)