Endothelial Extracellular Vesicles as Biomarkers of Endothelial Activation in Adults With Newly Diagnosed Hypertension (HYPER-endoEV-a)

July 22, 2026 updated by: Ines Drenjancevic, Josip Juraj Strossmayer University of Osijek

Endothelial Extracellular Vesicles as Biomarkers of Blood Pressure-Induced Endothelial Activation in Adults With Newly Diagnosed Untreated Hypertension

Hypertension is associated with endothelial dysfunction, an early event in the development of cardiovascular disease. Endothelial extracellular vesicles (EEVs) have emerged as promising biomarkers of endothelial activation and vascular injury; however, their relationship with blood pressure and microvascular endothelial function in untreated hypertension remains insufficiently understood. This observational case-control study aims to compare circulating EEV concentrations between normotensive adults and adults with newly diagnosed, untreated primary hypertension. In addition, the study will investigate the associations between EEV levels, blood pressure, microvascular endothelial function assessed by laser Doppler flowmetry, and established circulating biomarkers of endothelial activation. The findings may improve understanding of the role of EEVs in early hypertension and support their potential use as non-invasive biomarkers of endothelial dysfunction and cardiovascular risk.

Study Overview

Status

Recruiting

Conditions

Study Type

Observational

Enrollment (Estimated)

80

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Contact Backup

Study Locations

  • Croatia
      • Osijek, Croatia, 31000
        • Recruiting
        • Faculty of Medicine Osijek
        • Contact:
        • Contact:
        • Principal Investigator:
          • Ivana Tolj, MD, PhD
        • Sub-Investigator:
          • Marko Stupin, MD, PhD

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Adult
  • Older Adult

Accepts Healthy Volunteers

Yes

Sampling Method

Non-Probability Sample

Study Population

The study population will consist of adult men and women aged 18 years and older recruited from the outpatient clinics of the University Hospital Centre Osijek, Croatia. The study will include normotensive individuals and patients with newly diagnosed, previously untreated primary hypertension. Healthy volunteers will serve as the control group.

Description

Inclusion Criteria:

  • Adults aged 18 years or older.
  • Ability and willingness to provide written informed consent.
  • Normotensive individuals or individuals with newly diagnosed, previously untreated primary hypertension, classified according to the European Society of Hypertension (ESH) guidelines.
  • Ability to comply with all study procedures.

Exclusion Criteria:

  • Secondary hypertension.
  • Previous treatment with antihypertensive medication.
  • History of cardiovascular disease (except newly diagnosed primary hypertension in the hypertensive group).
  • Diabetes mellitus.
  • Chronic kidney disease.
  • Cerebrovascular disease.
  • Peripheral arterial disease.
  • Acute or chronic inflammatory or infectious disease.
  • Active malignancy.
  • Pregnancy or breastfeeding.
  • Current use of oral contraceptives, hormone replacement therapy, or medications known to affect endothelial function.
  • Inability or unwillingness to provide informed consent.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

Cohorts and Interventions

Group / Cohort
Normotensive Controls
Adults aged 18 years or older with normal office blood pressure according to the European Society of Hypertension (ESH) guidelines and without a history of hypertension or antihypertensive treatment.
Adults With Newly Diagnosed Untreated Primary Hypertension
Adults aged 18 years or older with newly diagnosed, previously untreated primary hypertension according to the European Society of Hypertension (ESH) guidelines and no prior use of antihypertensive medication.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Plasma endothelial extracellular vesicle concentration
Time Frame: Baseline
Concentration of circulating endothelial extracellular vesicles quantified by flow cytometry following size-exclusion chromatography isolation.
Baseline

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Acetylcholine-induced vasodilation (AChID)
Time Frame: Baseline
Endothelium-dependent microvascular vasodilation assessed by acetylcholine iontophoresis and laser Doppler flowmetry.
Baseline
Sodium nitroprusside-induced vasodilation (SNPID)
Time Frame: Baseline
Endothelium-independent microvascular vasodilation assessed by sodium nitroprusside iontophoresis and laser Doppler flowmetry.
Baseline
VCAM-1 concentration
Time Frame: Baseline
Plasma vascular cell adhesion molecule-1 (VCAM-1) concentration measured as a marker of endothelial activation.
Baseline
ICAM-1 concentration
Time Frame: Baseline
Plasma intercellular adhesion molecule-1 (ICAM-1) concentration measured as a marker of endothelial activation.
Baseline
Endocan concentration
Time Frame: Baseline
Plasma endocan concentration measured as a marker of endothelial dysfunction.
Baseline
Matrix metalloproteinase-9 (MMP-9)
Time Frame: Baseline
Plasma MMP-9 concentration measured as a marker of vascular remodeling and endothelial dysfunction.
Baseline
PORH response (R-O%)
Time Frame: Baseline
Microvascular endothelium-dependent vasodilation assessed by laser Doppler flowmetry following 1-minute arterial occlusion.
Baseline

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Josip Juraj Strossmayer University of Osijek

Collaborators

Osijek University Hospital

Investigators

  • Study Chair: Ana Stupin, MD, PhD, Faculty of Medicine Osijek, Josip Juraj Strossmayer of Osijek

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

May 1, 2026

Primary Completion (Estimated)

April 30, 2029

Study Completion (Estimated)

September 30, 2029

Study Registration Dates

First Submitted

July 22, 2026

First Submitted That Met QC Criteria

July 22, 2026

First Posted (Actual)

July 27, 2026

Study Record Updates

Last Update Posted (Actual)

July 27, 2026

Last Update Submitted That Met QC Criteria

July 22, 2026

Last Verified

May 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • HYPER-endoEV-adults

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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