Multi-Omics to Predict the Blood Pressure Response to Antihypertensives

Exclusion Criteria

• •A potential subject who meets any of the following criteria will be excluded from participation in this study:
• •Treatment with 2 or more antihypertensive drugs \< 3 months before inclusion. It is not allowed to stop medication for study purposes in subjects treated with 2 or more anti-hypertensive drugs.
• •Known diagnosis of secondary hypertension to an identifiable cause other than treated sleep apnea (e.g., hyperaldosteronism, renal artery stenosis, pheochromocytoma, Cushing's syndrome, coarctation of the aorta, uncontrolled hyper- or hypothyroidism and intracranial tumor)
• •Use of VEGF inhibitors, calcineurin inhibitors, glucocorticosteroids, erythropoietin stimulation agents, daily use of NSAID's
• •Use of MDMA, methamphetamine, cocaine
• •Use of glycyrrhetinic acid containing products , i.e. liquorice, specific herbal teas, \<4 weeks before inclusion. (If patients are willing to stop the intake of glycyrrhetinic acid containing products for the duration of the trial, they can be rescreened after 4 weeks of stopping glycyrrhetinic acid containing products)
• •Use of potassium containing supplements
• •Concurrent use of medication or a supplement with significant drug interaction with study medication. Special attention is warranted for amlodipine which is metabolized by Cyp3A4. Subjects using strong inhibitors or inducers of Cyp3A4 are excluded from participation in this trial. A list of strong inhibitors and inducers is provided in Addendum 1 of this protocol. For information on possible drug interactions we refer to the website of Lexi-Interact Online (Lexicomp® Drug Interactions - UpToDate (doctorabad.com): https://doctorabad.com/UpToDate/d/di.htm).
• •History of myocardial infarction, angina pectoris
• •History of atrial fibrillation
• •History of severe valvular or structural heart disease (excluding left ventricular hypertrophy)
• •History of NYHA class III or IV heart failure or known reduced left ventricular function (ejection fraction (EF) \<30%)
• •History of cerebrovascular accident or transient ischemic attack
• •History of hypertensive crisis
• •History of liver failure
• •History of skin cancer
• •History of gout
• •Current hyperparathyroidism
• •Current biliary tract obstruction
• •Pregnancy
• •Life expectancy \< 1 year
• •Known side effect or contra-indication to treatment with calcium channel blockers
• •Known side effect or contra-indication to treatment with angiotensin II receptor blockers
• •Known side effect or contra-indication to treatment with thiazide diuretics
• •Arm circumference \> 46 cm
• •Sodium level outside reference range at screening visit
• •Potassium level outside reference range at screening visit
• •Calcium level outside reference range at screening visit
• •eGFR \< 50 ml/min/1,73m2
• •Use of loop diuretics.