RecruitingPhase 2NCT04055428

NAUTICAL: Effect of Natriuretic Peptide Augmentation on Cardiometabolic Health in Black Individuals

The Effects of Natriuretic Peptide Augmentation on Cardiometabolic Health in Black Individuals (NAUTICAL)


Sponsor

University of Alabama at Birmingham

Enrollment

200 participants

Start Date

Aug 15, 2020

Study Type

INTERVENTIONAL

Conditions

Summary

Black individuals are more likely to have decreased insulin sensitivity which results in a high risk for the development of cardiometabolic disease. The reasons for this are incompletely understood. Natriuretic peptides (NPs) are hormones produced by the heart that play a role in regulating the metabolic health of an individual. Low circulating level of NPs is an important contributor to increased risk for diabetes. The NP levels are relatively lower among Black individuals thus affecting their metabolic health and putting them at a higher risk for diabetes. This study aims to test the hypothesis that by augmenting NP levels using sacubitril/valsartan, among Black Individuals one can improve their metabolic health (as measured by insulin sensitivity \& energy expenditure) and help establish the role of NPs in the underlying mechanism behind increased risk for cardiometabolic disease in these population.


Eligibility

Min Age: 18 Years

Inclusion Criteria3

  • Adults: Age more than or equal to 18 years of age
  • Self-identified race/ethnicity as African-American or Black
  • Blood pressure: 120-160/80-100 mmHg

Exclusion Criteria13

  • Women who are pregnant or breastfeeding or who can become pregnant and not practicing an acceptable method of birth control during the study (including abstinence)
  • Have any past or present history of cardiovascular diseases (stroke, myocardial infarction, heart failure, transient ischemic attack, angina, or cardiac arrhythmia)
  • BP more than 160/100 mmHg
  • BMI \>45 kg/m2
  • History of diabetes or fasting plasma glucose \>=126 mg/dL or HbA1C\>=6.5%
  • History of angioedema
  • Current or past (\<12 months) history of smoking
  • Estimated GFR \< 60 ml/min/1.73 m2; albumin-creatinine ratio ≥30 mg/g
  • Hepatic Transaminase (AST and ALT) levels \>3x the upper limit of normal
  • Significant psychiatric illness or seizure disorder
  • More than 2 Alcoholic drinks daily
  • Anemia (men, Hct \< 38%, Hb\<13 g/dL; women, Hct \<36%, Hb \<12 g/dL)
  • Inability to exercise on a treadmill

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Interventions

DRUGSacubitril, Valsartan 97-103 mg Oral Tablet

The subject will be randomized, in a double-blind manner to sacubitril/valsartan 97/103 mg twice daily for a period of 12 weeks.

DRUGValsartan 160 mg

The subject will be randomized, in a double-blind manner to valsartan 160 mg twice daily for a period of 12 weeks.

OTHERIntravenous Glucose Tolerance Test

An assessment of the insulin sensitivity will be done using the IVGTT, at baseline and after 12 weeks of pharmacological interventions.

DIETARY_SUPPLEMENTStandardized Meals

Participants will consume the standardized study mixed meal for the assessment of postprandial GLP-1 response to the meal.

OTHERExercise capacity VO2 maximum determination

Each participant's maximal oxygen capacity will be determined using modified Bruce treadmill protocol.


Locations(1)

University of Alabama at Birmingham

Birmingham, Alabama, United States

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NCT04055428


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