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.
調査の概要
状態
条件
研究の種類
入学 (推定)
段階
- 適用できない
連絡先と場所
研究連絡先
- 名前:Ji Young Yoon
- 電話番号:82-10-2704-4542
- メール:seecross2846@snu.ac.kr
研究連絡先のバックアップ
- 名前:Seung-Mok Lee, MD
- 電話番号:82-10-7185-4340
- メール:mokmom@snu.ac.kr
研究場所
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Daegu、韓国
- Kyungpook National University Hospital
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コンタクト:
- Jang Hoon Lee, MD, PhD
- 電話番号:82-53-200-6414
- メール:ljhmh75@knu.ac.kr
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Seoul、韓国
- Korea University Anam Hospital
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コンタクト:
- Hyung Joon Joo, MD, PhD
- 電話番号:82-2-2286-1214
- メール:drjoohj@gmail.com
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Seoul、韓国
- Korea University Guro Hospital
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Seoul、韓国
- Seoul National University Hospital
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コンタクト:
- Hae-Young Lee, MD, PhD
- 電話番号:82-10-4528-6160
- メール:hylee612@snu.ac.kr
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Seoul、韓国
- The Catholic University of Korea, Seoul St. Mary's Hospital
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コンタクト:
- Woo-Baek Chung, MD, PhD
- 電話番号:82-2-2258-1134
- メール:peace816@catholic.ac.kr
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Seoul、韓国
- Seoul National University Boramae Medical Center
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コンタクト:
- Hack-Lyoung Kim, MD, PhD
- 電話番号:82-2-870-3235
- メール:khl2876@gmail.com
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Seoul、韓国
- Kyung Hee University Hospital at Gangdong
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コンタクト:
- Il-Suk Sohn, MD, PhD
- 電話番号:82-10-8772-4662
- メール:issohn@khu.ac.kr
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Gyeonggi-do
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Seongnam-si、Gyeonggi-do、韓国
- Seoul National University Bundang Hospital
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コンタクト:
- Kwang-Il Kim, MD, PhD
- 電話番号:82-31-787-7032
- メール:kikim907@gmail.com
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Uijeongbu-si、Gyeonggi-do、韓国
- The Catholic University of Korea, Uijeongbu ST. Mary's Hospital
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コンタクト:
- Hyo-Suk Ahn, MD, PhD
- 電話番号:82-10-4223-9201
- メール:alaco0502@gmail.com
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参加基準
適格基準
就学可能な年齢
- 大人
- 高齢者
健康ボランティアの受け入れ
説明
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
研究計画
研究はどのように設計されていますか?
デザインの詳細
- 主な目的:処理
- 割り当て:ランダム化
- 介入モデル:並列代入
- マスキング:独身
武器と介入
参加者グループ / アーム |
介入・治療 |
|---|---|
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実験的: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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アクティブコンパレータ: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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この研究は何を測定していますか?
主要な結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
|
Number of participants with new cardiovascular events
時間枠: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
|
二次結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
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Number of participants with death due to cardiovascular causes
時間枠: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.
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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 nonfatal stroke
時間枠:From randomization until the occurrence of the respective outcome or the end of follow-up, up to 5 years
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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
時間枠:From randomization until the occurrence of the respective outcome or the end of follow-up, up to 5 years
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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
時間枠: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.
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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 acute decompensated heart failure
時間枠: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
|
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Number of participants with unstable angina with hospitalization
時間枠: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
|
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Number of participants with chronic kidney disease
時間枠: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
|
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Number of participants with atrial fibrillation
時間枠: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
|
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Number of participants with left ventricular hypertrophy
時間枠: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
|
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Win ratio for the hierarchical composite outcome
時間枠:From randomization through the end of follow-up, up to 5 years
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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
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その他の成果指標
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
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Long-Term Cardiovascular Outcomes During Extended Follow-up
時間枠:From randomization through the end of extended follow-up, up to 10 years
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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.
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From randomization through the end of extended follow-up, up to 10 years
|
協力者と研究者
捜査官
- 主任研究者:Hae-Young Lee, MD, PhD、Seoul National University Hospital
研究記録日
主要日程の研究
研究開始 (推定)
一次修了 (推定)
研究の完了 (推定)
試験登録日
最初に提出
QC基準を満たした最初の提出物
最初の投稿 (実際)
学習記録の更新
投稿された最後の更新 (実際)
QC基準を満たした最後の更新が送信されました
最終確認日
詳しくは
本研究に関する用語
その他の研究ID番号
- CUFFLESS
医薬品およびデバイス情報、研究文書
米国FDA規制医薬品の研究
米国FDA規制機器製品の研究
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