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

Black Americans have lower levels of a heart-protective hormone called natriuretic peptide, which may partly explain why they have higher rates of high blood pressure and heart disease. The NAUTICAL study tests a drug called sacubitril/valsartan that boosts natriuretic peptide levels, to see whether it improves heart and metabolic health in Black individuals with mildly elevated blood pressure. This trial enrolls self-identified Black or African-American adults with blood pressure in a specific range (120–160/80–100 mmHg). Participants must be able to exercise on a treadmill. People with a history of cardiovascular disease, diabetes, smoking in the past year, or kidney disease are excluded. You may be eligible if: - You are 18 years or older - You self-identify as African-American or Black - Your blood pressure is between 120–160 systolic and 80–100 diastolic mmHg - You are able to exercise on a treadmill You may NOT be eligible if: - You have a history of cardiovascular disease (stroke, heart attack, heart failure, angina, arrhythmia) - You have diabetes or a fasting blood sugar of 126 mg/dL or higher - You have a history of angioedema - You have smoked in the past 12 months - Your estimated kidney filtration rate (GFR) is below 60 mL/min - You have significant liver enzyme elevations (above 3x normal) - You drink more than 2 alcoholic drinks daily - You are pregnant, breastfeeding, or not using contraception Talk to your doctor to see if this trial is right for you.