Short summary

The main purpose of this multicenter interdisciplinary study is to improve our understanding of the complex mechanisms underlying the development of Cardiovascular Disease (CVD) in hypertension in order to improve prevention and treatment through more individualized and better targeted methods. These improvements will eventually give greater health for less money.

We hypothesize that better description of risk factor exposure over time, taking into account new risk factors, risk factor interactions and genetic variations (individual susceptibility), can improve the prediction of subclinical cardiovascular target organ damage (TOD), changes in TOD and future CVD in patients with hypertension beyond that allowed by focusing only on traditional risk factors.

Description of the cohort

In approximately 30 European Society of Hypertension (ESH) Excellence Centers throughout Europe we will consecutively enroll 1.500 subjects aged 18-80 years with office blood pressure ? 140/90 mmHg or ongoing antihypertensive treatment. The subjects will be thoroughly investigated at inclusion and after one year of antihypertensive treatment following ESH guidelines and followed for five years. Subjects with known cancer, known life expectancy less than 1 year or inability to give written consent will be excluded.

Data and biological material

Blood samples are taken and processed using local equipment. Blood samples for the biobank are stored at -80 degree Celsius and shipped to OPENs biobank.

In all patients we will measure selected genetics, traditional risk factors (age, gender, smoking, blood pressure etc.), 24-hour blood pressure, home blood pressure, new biomarkers (Cystatin C, soluble urokinase plasminogen activator receptor, high sensitivity C-reactive protein, high sensitivity Troponin T, N-terminal pro brain natriuretic peptide) and different markers of TOD (urine albumin/creatinine ratio, left ventricular (LV) mass index, LV relative wall thickness, LV ejection fraction etc.). Proteomics in urine will be measured in subgroups characterized by not receiving antihypertensive treatment and having either marked TOD with very high or low risk based on SCORE or no TOD. Extra blood and urine samples will be kept for later analyzes.

Collaborating researchers and departments

Department of Endocrinology, Odense University Hospital

• Professor and Senior Hospital Physician Michael Hecht Olsen

Istanbul University Cerrahpasa, School of Medicine, Turkey

• Professor Serap Erdine, MD

Centre of Cardiology, North Estonia Medical Centre, Tallinn, Estonia

• Head of Center, Professor Margus Viigimaa, MD

Department of Pharmacology, Hospital European Georges Pompidou, Paris, France

• Professor Stéphane Laurent, MD, PhD

Department of Medical and Surgical Sciences, Clinic of Internal Medicine, University of Brescia, Italy

• Professor Enrico Agabiti-Rosei

Clinica Medica, University of Milano-Bicocca, Ospedale San Gerardo, Italy

• Professor Giuseppe Mancia, MD

Department of Cardiology, S.Luca Hospital, Istituto Auxologico Italiano IRCCS, Milan & University of Milano-Bicocca, Italy

• Professor Gianfranco Parati, MD, PhD

Internal Medicine, Hospital Clinico, University of Valencia, Spain

• Professor Josep Redon, MD 

Medizinische Klinik, University Erlangen-Nuernberg, Germany

• Professor Roland E. Schmieder, DMSc

Department of Preventive Cardiology, Inst.Clin.Exp.Medicine, Prague, Czech Republic

• Professor Renata Cifkova, MD, PhD

BHF Glasgow Cardiovascular Research Centre, University of Glasgow, UK

• Head of College and Professor Anna Dominiczak, MD

Department of Cardiology, Ullevaal University Hospital, Oslo, Norway

• Professor and Chief Physician Sverre E. Kjeldsen

Clinica Medica III, Policlinico Sant'Orsola Malpighi, Bologna, Italy

• Professor Ettore Ambrosioni

Centre for Clinical Pharmacology, Barts and the London Queen Mary's School of Medicine and Dentistry, London, UK

• Head of Institute and Professor Mark Caulfield, MD

Vascular Risk Prevention Unit, Hospital Clínico, University of Barcelona, Spain

• Professor Antonio Coca, MD, PhD

University of Ghent, Belgium

• Professor Denis Clement

Emory University, Department of Cardiology, Asklepeion General Hospital, Athens, Greece

• Professor Athanasios Manolis

Division of Nephrology and Hypertension, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland

• Professor Michel Brunnier, MD 

Department of Pharmacology and Toxicology, Universiteit Maastricht, Maastricht, Holland

• Professor Harry Struijker-Boudier, MD

University of Milan, Istituto Auxologico Italiano, Italy

• Professor, Alberto Zanchetti MD, PhD

Department of Hypertension and Diabetology, Medical University of Gdansk, Poland

• Head of Unit and Professor Krzysztof Narkiewicz, MD, PhD

Department of Clinical Sciences Medicine, University Hospital, Malmö, Sweden

• Professor Peter Nilsson, MD, PhD