THE PREDICTIVE ROLE OF URINARY PROTEOMICS IN BLOOD PRESSURE RESPONSE OF OBESE HYPERTENSIVE PATIENTS, TREATED WITH IRBESARTAN OR EPLERENONE: STUDY DESIGN AND BASELINE CHARACTERISTIC

Objective: Despite the available means of treating primary arterial hypertension, the prevalence of hypertensive patients with inadequately controlled blood pressure levels, remains high. The identification of biomarkers with prognostic and predictive role, seems to play an important role in the management of hypertensive patients. Proteomic analysis studies provide encouraging results in the identification of such biomarkers. The goal of this clinical study is to is to highlight peptides through urinary proteomic analysis of obese hypertensive patients, capable of predicting blood pressure response, following treatment with irbesartan or eplerenone Design and method: In this interventional study, untreated obese hypertensive patients will be randomized into two pharmacological treatment groups, Irbesartan 150 mg od and Eplerenone 25 mg bid. Blood pressure response will be assessed based on a baseline visit prior to the initiation of pharmacological treatment and a follow-up visit after an 8-week interval. Patients will be categorized as either responders or non-responders based on the changes in their blood pressure levels. The analysis of patient’s baseline urinary samples will be conducted using Liquid Chromatography with tandem mass spectrometry (LC-MS/MS). Results: We enrolled a total of 109 patients,42% female, with mean age 56 years old, mean BMI 34.134 k/m2. 53 patients were treated with Eplerenone 25 mg bid, with mean baseline 24 h ABPM 142.3 mmHg SBP and 85.3 mmHg DBP, while 56 patients were treated with Irbesartan 150 mg od, with mean baseline 24 h ABPM 137.84mmHg SBP and 82.8mmHg DBP. Blood pressure response is yet to be determined after an 8 week follow-up visit. Conclusions: The examination of individual urinary peptides, along with the evaluation of blood pressure response, will be employed to pinpoint distinct urinary proteins that can act as predictive biomarkers in regards to blood pressure alterations after pharmacological treatment with irbesartan or eplerenone, in obese hypertensive patients.