DESCRIPTION (provided by applicant): The candidate for this K23 award is dedicated to becoming an independent patient-oriented investigator with expertise in biomarker development and evaluation, clinical trials, and mineralocorticoid-induced hypertension. The proposed award will allow the candidate to accomplish this goal while evaluating a novel biomarker of mineralocorticoid receptor (MR) activation for use in tailored antihypertensive therapy. Candidate. The candidate is well prepared for this award because of his prior training. After internal medicine residency, he investigated the pathophysiology of angiotensin-converting enzyme inhibitor (ACEi)-associated angioedema in Vanderbilt University's Division of Clinical Pharmacology. While receiving excellent training in the clinical management of hypertension, he enrolled study participants and assayed their samples in the laboratory, igniting a passion for patient-oriented research. He earned Vanderbilt's Master of Science in Clinical Investigation degree. In addition, he helped conduct a randomized trial to treat acute ACEi-associated angioedema while developing an animal model recapitulating important aspects of this rare, but potentially fatal problem. Based upon a growing interest in hypertension and cardiovascular disease, he completed a clinical cardiovascular medicine fellowship at the University of Colorado, where he was elected the Gilbert Blount Endowed Research Fellow. During this fellowship, he maintained a research focus on hypertension. Upon recruitment to the University of Michigan, he has turned his attention to a problem of major public health importance: tailored treatment of patients with hypertension. The candidate is a cardiologist, and American Society of Hypertension-Certified Hypertension Specialist. He is well positioned to become a leader in patient-oriented hypertension research. His background in patient- oriented research has prepared him to become an expert in the clinical investigation of mineralocorticoid-induced hypertension. His research independence will be achieved through three Training Objectives: (1) comprehensive laboratory and statistical training relevant to biomarkers of human MR activation, (2) in-depth training in endocrine hypertension and aldosterone's effects on human physiology, and (3) experience directing a randomized controlled trial (RCT). Environment. The proposed research and training will take place at the University of Michigan, which has a proud legacy of seminal mineralocorticoid research. The candidate is a faculty member in Cardiovascular Medicine, which has close collaborative ties with the Division of Metabolism, Endocrinology, and Diabetes; the Department of Physiology; and the University of Michigan's CTSA, the Michigan Institute for Clinical and Health Research. The proposed work will be completed under close mentorship from Drs. Richard Auchus, MD, PhD and William Rainey, PhD, recognized experts in mineralocorticoid biol...