Comparison of Office and Cuffless Ambulatory Blood Pressure-Guided Management in Patients With Hypertension (CUFFLESS)
Comparison of Clinical Outcomes Between Office and Cuffless Ambulatory Blood Pressure-guided Management in Patients With Hypertension
Hypertension is a major risk factor for cardiovascular and cerebrovascular diseases, including stroke and myocardial infarction. Blood pressure (BP) fluctuates throughout the day in response to physical activity, emotional states, and sleep. However, hypertension diagnosis and management are commonly based on BP measurements obtained in the clinic or at home, which may not fully reflect these variations. This can contribute to discrepancies between office and out-of-office BP, including white-coat and masked hypertension.
Ambulatory blood pressure monitoring (ABPM) provides information on BP throughout daily activities and sleep, but conventional cuff-based ABPM may be limited by discomfort, accessibility, and logistical challenges. Recently, cuffless wearable devices have enabled repeated BP monitoring without the use of a conventional inflatable cuff.
The CUFFLESS study is a multicenter, prospective, randomized controlled trial comparing two strategies for the management of hypertension: cuffless ambulatory BP-guided management and conventional office BP-guided management. Participants will be randomly assigned to either management strategy and followed for clinical outcomes. The primary objective is to determine whether hypertension management guided by cuffless ambulatory BP monitoring reduces the occurrence of cardiovascular events compared with management guided by conventional office BP measurements.
Studieoversigt
Status
Status
Betingelser
Betingelser
Intervention / Behandling
Intervention / Behandling
Undersøgelsestype
Undersøgelsestype
Tilmelding (Anslået)
Tilmelding
Fase
Fase
- Ikke anvendelig
Kontakter og lokationer
Studiekontakt
Studiekontakt
- Navn: Ji Young Yoon
- Telefonnummer: 82-10-2704-4542
- E-mail: seecross2846@snu.ac.kr
Undersøgelse Kontakt Backup
- Navn: Seung-Mok Lee, MD
- Telefonnummer: 82-10-7185-4340
- E-mail: mokmom@snu.ac.kr
Studiesteder
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Daegu, Sydkorea
- Kyungpook National University Hospital
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Kontakt:
- Jang Hoon Lee, MD, PhD
- Telefonnummer: 82-53-200-6414
- E-mail: ljhmh75@knu.ac.kr
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Seoul, Sydkorea
- Korea University Anam Hospital
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Kontakt:
- Hyung Joon Joo, MD, PhD
- Telefonnummer: 82-2-2286-1214
- E-mail: drjoohj@gmail.com
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Seoul, Sydkorea
- Korea University Guro Hospital
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Seoul, Sydkorea
- Seoul National University Hospital
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Kontakt:
- Hae-Young Lee, MD, PhD
- Telefonnummer: 82-10-4528-6160
- E-mail: hylee612@snu.ac.kr
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Seoul, Sydkorea
- The Catholic University of Korea, Seoul St. Mary's Hospital
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Kontakt:
- Woo-Baek Chung, MD, PhD
- Telefonnummer: 82-2-2258-1134
- E-mail: peace816@catholic.ac.kr
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Seoul, Sydkorea
- Seoul National University Boramae Medical Center
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Kontakt:
- Hack-Lyoung Kim, MD, PhD
- Telefonnummer: 82-2-870-3235
- E-mail: khl2876@gmail.com
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Seoul, Sydkorea
- Kyung Hee University Hospital at Gangdong
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Kontakt:
- Il-Suk Sohn, MD, PhD
- Telefonnummer: 82-10-8772-4662
- E-mail: issohn@khu.ac.kr
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Gyeonggi-do
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Seongnam-si, Gyeonggi-do, Sydkorea
- Seoul National University Bundang Hospital
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Kontakt:
- Kwang-Il Kim, MD, PhD
- Telefonnummer: 82-31-787-7032
- E-mail: kikim907@gmail.com
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Uijeongbu-si, Gyeonggi-do, Sydkorea
- The Catholic University of Korea, Uijeongbu ST. Mary's Hospital
-
Kontakt:
- Hyo-Suk Ahn, MD, PhD
- Telefonnummer: 82-10-4223-9201
- E-mail: alaco0502@gmail.com
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Deltagelseskriterier
Berettigelseskriterier
Berettigelseskriterier
Aldre berettiget til at studere
- Voksen
- Ældre voksen
Tager imod sunde frivillige
Beskrivelse
Inclusion Criteria:
- 24 hour mean SBP ≥ 130 mmHg by cuffless ambulatory BP monitor
- aged ≥30 and <80 years
- voluntarily decide to participate in this clinical trial and provide written informed consent after being adequately informed.
- willing and able to comply with the requirements of the study protocol
Exclusion Criteria:
- Did not agree with this clinical trial and did not provide informed consent
- Office SBP ≥ 190 mmHg, or diastolic BP (DBP) < 60 mmHg.
- Diagnosed secondary hypertension.
- Hospitalization for stroke, myocardial infarction (MI) or unstable angina within the last 6 months
- Coronary revascularization (percutaneous coronary intervention [PCI] or coronary artery bypass grafting [CABG]) within the last 12 months.
- Planned to perform coronary revascularization (PCI or CABG) in the next 12 months.
- History of sustained atrial fibrillation (AF) or ventricular arrhythmias at entry influencing the BP measurement of ring-type cuffless BP monitoring device.
- Severe valvular disease or valvular disease likely to require surgery or percutaneous valve replacement during the trial.
- Underlying heart disease: Hypertrophic cardiomyopathy (HCM), dilated cardiomyopathy (DCM), rheumatic heart disease or congenital heart disease
- Uncontrolled diabetes mellitus (serum fasting glucose > 200 mg/dL or glycated hemoglobin [HbA1c] >8%).
- Severe liver dysfunction (alanine aminotransferase [ALT] > 3 times the upper limit of normal (ULN) value).
- Severe renal dysfunction (end stage renal disease [ESRD] on dialysis or estimated glomerular filtration rate [eGFR] <30 ml/min/1.73m², or serum creatinine >2.5 mg/dL.
- Malignancy history within 5 years.
- Severe cognitive impairment or mental disorders.
- Participating in other clinical trials other than observation registry
Studieplan
Hvordan er undersøgelsen tilrettelagt?
Design detaljer
- Primært formål: Behandling
- Tildeling: Randomiseret
- Interventionel model: Parallel tildeling
- Maskning: Enkelt
Antal våben
Våben og indgreb
Deltagergruppe / ArmDeltagergruppe / Arm |
Intervention / BehandlingIntervention / Behandling |
|---|---|
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Eksperimentel: Cuffless ambulatory blood pressure-guided management group
Participants assigned to this group will receive hypertension management guided by both office blood pressure and 24-hour ambulatory blood pressure measured using a cuffless BP monitoring device.
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Participants will undergo 24-hour ambulatory blood pressure monitoring using a cuffless blood pressure monitoring device at least annually.
Antihypertensive treatment will be adjusted based on both office and cuffless ambulatory blood pressure measurements, with target systolic blood pressure values of <140 mmHg for office BP, <135 mmHg for daytime mean BP, <120 mmHg for nighttime mean BP, and <130 mmHg for 24-hour mean BP.
|
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Aktiv komparator: Office blood pressure-guided management group
Participants assigned to this group will receive conventional hypertension management guided by office blood pressure measurements.
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Participants will receive conventional hypertension management guided by office blood pressure measurements, with a target office systolic blood pressure of <140 mmHg.
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Hvad måler undersøgelsen?
Primære resultatmål
Primære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
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Number of participants with new cardiovascular events
Tidsramme: From randomization until the first occurrence of a primary outcome event or the end of follow-up, up to 5 years
|
New cardiovascular events, defined as a composite of death due to cardiovascular causes, nonfatal stroke, myocardial infarction, acute decompensated heart failure, unstable angina with hospitalization, coronary revascularization, chronic kidney disease, atrial fibrillation and left ventricular hypertrophy.
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From randomization until the first occurrence of a primary outcome event or the end of follow-up, up to 5 years
|
Sekundære resultatmål
Sekundære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
|
Number of participants with death due to cardiovascular causes
Tidsramme: From randomization until the occurrence of the respective outcome or the end of follow-up, up to 5 years
|
Occurrence of death due to cardiovascular causes, analyzed as an individual component of the primary composite outcome.
|
From randomization until the occurrence of the respective outcome or the end of follow-up, up to 5 years
|
|
Number of participants with nonfatal stroke
Tidsramme: From randomization until the occurrence of the respective outcome or the end of follow-up, up to 5 years
|
Occurrence of nonfatal stroke, analyzed as an individual component of the primary composite outcome.
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From randomization until the occurrence of the respective outcome or the end of follow-up, up to 5 years
|
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Number of participants with myocardial infarction
Tidsramme: From randomization until the occurrence of the respective outcome or the end of follow-up, up to 5 years
|
Occurrence of myocardial infarction, analyzed as an individual component of the primary composite outcome.
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From randomization until the occurrence of the respective outcome or the end of follow-up, up to 5 years
|
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Number of participants with coronary revascularization
Tidsramme: From randomization until the occurrence of the respective outcome or the end of follow-up, up to 5 years
|
Occurrence of coronary revascularization, analyzed as an individual component of the primary composite outcome.
|
From randomization until the occurrence of the respective outcome or the end of follow-up, up to 5 years
|
|
Number of participants with acute decompensated heart failure
Tidsramme: From randomization until the occurrence of the respective outcome or the end of follow-up, up to 5 years
|
Occurrence of acute decompensated heart failure, analyzed as an individual component of the primary composite outcome.
|
From randomization until the occurrence of the respective outcome or the end of follow-up, up to 5 years
|
|
Number of participants with unstable angina with hospitalization
Tidsramme: From randomization until the occurrence of the respective outcome or the end of follow-up, up to 5 years
|
Occurrence of unstable angina with hospitalization, analyzed as an individual component of the primary composite outcome.
|
From randomization until the occurrence of the respective outcome or the end of follow-up, up to 5 years
|
|
Number of participants with chronic kidney disease
Tidsramme: From randomization until the occurrence of the respective outcome or the end of follow-up, up to 5 years
|
Occurrence of chronic kidney disease, analyzed as an individual component of the primary composite outcome.
|
From randomization until the occurrence of the respective outcome or the end of follow-up, up to 5 years
|
|
Number of participants with atrial fibrillation
Tidsramme: From randomization until the occurrence of the respective outcome or the end of follow-up, up to 5 years
|
Occurrence of atrial fibrillation, analyzed as an individual component of the primary composite outcome.
|
From randomization until the occurrence of the respective outcome or the end of follow-up, up to 5 years
|
|
Number of participants with left ventricular hypertrophy
Tidsramme: From randomization until the occurrence of the respective outcome or the end of follow-up, up to 5 years
|
Occurrence of left ventricular hypertrophy, analyzed as an individual component of the primary composite outcome.
|
From randomization until the occurrence of the respective outcome or the end of follow-up, up to 5 years
|
|
Win ratio for the hierarchical composite outcome
Tidsramme: From randomization through the end of follow-up, up to 5 years
|
The hierarchical composite outcome will be analyzed using the win ratio approach, prioritizing events in the following order of clinical importance: (1) death due to cardiovascular causes; (2) nonfatal stroke, myocardial infarction, or acute decompensated heart failure; (3) unstable angina with hospitalization; and (4) coronary revascularization, chronic kidney disease, atrial fibrillation, or left ventricular hypertrophy.
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From randomization through the end of follow-up, up to 5 years
|
Andre resultatmål
Andre resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
|
Long-Term Cardiovascular Outcomes During Extended Follow-up
Tidsramme: From randomization through the end of extended follow-up, up to 10 years
|
Long-term occurrence of the composite cardiovascular outcome, defined as death due to cardiovascular causes, nonfatal stroke, myocardial infarction, acute decompensated heart failure, unstable angina with hospitalization, coronary revascularization, chronic kidney disease, atrial fibrillation and left ventricular hypertrophy, will be assessed using administrative claims and other available follow-up data.
|
From randomization through the end of extended follow-up, up to 10 years
|
Samarbejdspartnere og efterforskere
Sponsor
Sponsor
Samarbejdspartnere
Samarbejdspartnere
Efterforskere
Efterforskere
- Ledende efterforsker: Hae-Young Lee, MD, PhD, Seoul National University Hospital
Datoer for undersøgelser
Studer store datoer
Studiestart (Anslået)
Studiestart
Primær færdiggørelse (Anslået)
Primær færdiggørelse
Studieafslutning (Anslået)
Studieafslutning
Datoer for studieregistrering
Først indsendt
Først indsendt
Først indsendt, der opfyldte QC-kriterier
Først indsendt, der opfyldte QC-kriterier
Først opslået (Faktiske)
Først opslået
Opdateringer af undersøgelsesjournaler
Sidste opdatering sendt (Faktiske)
Sidste opdatering sendt
Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier
Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier
Sidst verificeret
Sidst verificeret
Mere information
Begreber relateret til denne undersøgelse
Yderligere relevante MeSH-vilkår
Andre undersøgelses-id-numre
Andre undersøgelses-id-numre
- CUFFLESS
Lægemiddel- og udstyrsoplysninger, undersøgelsesdokumenter
Studerer et amerikansk FDA-reguleret lægemiddelprodukt
Studerer et amerikansk FDA-reguleret enhedsprodukt
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