As part of our collaborative spirit to improve the lives of patients with hypertension, the Stanford Hypertension Center has partnered with several groups with expertise in clinical research. 

The Stanford Center for Clinical Research (SCCR) is an academic research organization which currently sits within Department of Medicine at Stanford School of Medicine. The SCCR has faculty with expertise in multiple therapeutic areas representative of a large school of medicine and areas of clinical research from translational sciences, clinical trials, outcomes, health services research and quantitative sciences. The SCCR has a robust infrastructure and processes in place to plan and execute single and multi-site clinical studies efficiently and effectively. With a full array of clinical research services essential for successful execution of single or multi-site studies supported by industry, foundations and government sponsors, the SCCR is well-positioned to collaborate with the Stanford Hypertension Center on exciting clinical trials.

Kenneth W. Mahaffey, MD, Director of SCCR and a Vice Chair of Clinical Research, Department of Medicine

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Stanford’s new Center for Digital Health (CDH) is focused on leveraging our resources and encouraging collaborations that will lead to better health care through digital technology. Home blood pressure measurement is already considered a necessity for the diagnosis of hypertension per new guidelines by the United States Preventative Services Task Force (Annals of Internal Medicine, October, 2015). Moreover, we know from the TASMIN-SR trial that increased patient awareness of blood pressure through home monitoring (McManus, et al, JAMA, 2014) leads to better blood pressure control. With the advent of new technologies both in Silicon Valley and beyond for measuring and reporting blood pressure and with the experience of our colleagues in clinical trial design, Stanford’s Center for Digital Health is ideally positioned to work with technology companies to utilize these new technologies in ways that are safe and effective for patient care. The Stanford Hypertension Center is actively working with members of the Center for Digital Health to bring these new technologies to blood pressure management to our patients at Stanford. For clinical trial operations, the Center for Digital Health works in collaboration with the Stanford Center for Clinical Research.

Sumbul Ahmad Desai, MD Executive Director of Stanford Center for Digital Health, Vice Chair of Strategy and Innovation, Department of Medicine

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Sleep apnea is now accepted as the leading treatable cause of hypertension and is a strong predictor of stroke and heart disease. Difficulty with memory, intimacy, and attention are common. Obstructive sleep apnea (OSA) is now accepted as the leading treatable cause of hypertension and is a strong predictor of stroke and heart disease. The relationship between OSA and hypertension is a major area of investigation for research studies at our Center.  

Clete Kushida, MD, PhD, FAASM, Professor of Psychiatry and Behavioral Sciences - Director, Stanford Center for Sleep Sciences and Medicine

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Blood pressure and kidney function go hand-in-hand. Blood pressure is primarily regulated by the kidneys, through effects on sodium and potassium handling, fluid balance, and hormonal regulation. When kidney function declines, blood pressure often becomes elevated. Likewise, high blood pressure can accelerate kidney function decline. Given the strong link between blood pressure and kidney function, Stanford's Kidney Clinical Research group has numerous projects focused on blood pressure research. For example, we were part of the Systolic Blood Pressure Intervention Trial (SPRINT), a seminal randomized clinical trial of blood pressure control, sponsored by the National Institutes of Health. Many of our faculty are also part of the clinical faculty of the Stanford Hypertension Center, and enjoy taking care of patients with difficult-to-treat blood pressure. Our goal is to better understand the relations among blood pressure, kidney function, and important clinical outcomes such as kidney disease progression and cardiovascular disease, in order to improve outcomes for our patients.

Tara Chang, MD, MAS, Director, Kidney Clinic Research

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Our faculty are working on ways to span molecular biology and the latest device research on blood pressure to "translate" to improvements in the diagnosis and management of hypertension. Our two long-term goals are: (1) to leverage human genetics to better understand resistant hypertension, and (2) to utilize existing technologies to better monitor and blood pressure in the ambulatory setting.

Genetic studies on patients with rare forms of hypertension have shown that regulation of sodium transport in the kidney is a key determinant of blood pressure, and mutations in particular genes can lead to hypertension. In addition many of the roles that the kidney plays in more common forms of hypertension are still unresolved. Below is a list of active projects conducted by Stanford faculty and collaborators worldwide on the molecular basis of hypertension.

The Annes laboratory is developing and studying animal models of the hereditary neuroendocrine tumor syndromes. These conditions are frequently associated with the formation of tumors (paragangliomas and pheochromocytomas) that produce blood pressure-elevating substances. Although these tumors are rare, they are an important diagnostic consideration in individuals with high blood pressure that is difficult to control and/or labile. Key objectives of Dr. Annes’ work are to enhance our current understanding of how these tumors form, the  genetic events that cause these tumors to become invasive and metastasize, and to identify effective treatments for disease that is not amenable to surgical cure.   

Justin Annes, MD, PhD, Assistant Professor, Division of Endocrinology and Metabolism

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The Bhalla laboratory studies the mechanisms of hypertension in the the metabolic syndrome. The metabolic syndrome is a clusters of disorders including obesity, diabetes, hypertension, and dyslipidemia, and Dr. Gerald Reaven here at Stanford University was one of the first to elucidate that insulin resistance was a common link among these disorders. Hypertension is a very common feature of the metabolic syndrome and is present in ~70-80% of individuals with obesity and in ~50% of patients with high levels of insulin, a surrogate for insulin resistance. The laboratory uses precise genetic models to study the role of insulin signaling in the kidney in diet-induced models of obesity and insulin resistance.

The Bhalla laboratory studies the mechanisms of CLC-Kb function. The chloride channel, CLC-Kb, is expressed in the distal nephron and mutations in this gene lead to genetic forms of hypotension, low blood pressure. Simliar mutations in the kidney lead to protection from hypertension and cardiovascular disease, and inhibitors of similar channels and transporters ("diuretics") are used as treatments for hypertension in humans. Despite its importance in human physiology little is known about what regulates CLC-Kb at the intracellular or extracellular level. The laboratory collaborates with scientists both within and outside Stanford in electrophysiology and chemistry to study the function of CLC-Kb, using a novel mutation that disables the channel.

Vivek Bhalla, MD, FASN; Director, Stanford Hypertension Center