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.
연구 개요
상태
상태
정황
정황
개입 / 치료
개입 / 치료
연구 유형
연구 유형
등록 (추정된)
등록
단계
단계
- 해당 없음
연락처 및 위치
연구 연락처
연구 연락처
- 이름: Ji Young Yoon
- 전화번호: 82-10-2704-4542
- 이메일: seecross2846@snu.ac.kr
연구 연락처 백업
- 이름: Seung-Mok Lee, MD
- 전화번호: 82-10-7185-4340
- 이메일: mokmom@snu.ac.kr
연구 장소
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Daegu, 대한민국
- Kyungpook National University Hospital
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연락하다:
- Jang Hoon Lee, MD, PhD
- 전화번호: 82-53-200-6414
- 이메일: ljhmh75@knu.ac.kr
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Seoul, 대한민국
- Korea University Anam Hospital
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연락하다:
- Hyung Joon Joo, MD, PhD
- 전화번호: 82-2-2286-1214
- 이메일: drjoohj@gmail.com
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Seoul, 대한민국
- Korea University Guro Hospital
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Seoul, 대한민국
- Seoul National University Hospital
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연락하다:
- Hae-Young Lee, MD, PhD
- 전화번호: 82-10-4528-6160
- 이메일: hylee612@snu.ac.kr
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Seoul, 대한민국
- The Catholic University of Korea, Seoul St. Mary's Hospital
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연락하다:
- Woo-Baek Chung, MD, PhD
- 전화번호: 82-2-2258-1134
- 이메일: peace816@catholic.ac.kr
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Seoul, 대한민국
- Seoul National University Boramae Medical Center
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연락하다:
- Hack-Lyoung Kim, MD, PhD
- 전화번호: 82-2-870-3235
- 이메일: khl2876@gmail.com
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Seoul, 대한민국
- Kyung Hee University Hospital at Gangdong
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연락하다:
- Il-Suk Sohn, MD, PhD
- 전화번호: 82-10-8772-4662
- 이메일: issohn@khu.ac.kr
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Gyeonggi-do
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Seongnam-si, Gyeonggi-do, 대한민국
- Seoul National University Bundang Hospital
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연락하다:
- Kwang-Il Kim, MD, PhD
- 전화번호: 82-31-787-7032
- 이메일: kikim907@gmail.com
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Uijeongbu-si, Gyeonggi-do, 대한민국
- The Catholic University of Korea, Uijeongbu ST. Mary's Hospital
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연락하다:
- Hyo-Suk Ahn, MD, PhD
- 전화번호: 82-10-4223-9201
- 이메일: alaco0502@gmail.com
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참여기준
자격 기준
자격 기준
공부할 수 있는 나이
- 성인
- 고령자
건강한 자원 봉사자를 받아들입니다
설명
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
공부 계획
연구는 어떻게 설계됩니까?
디자인 세부사항
- 주 목적: 치료
- 할당: 무작위
- 중재 모델: 병렬 할당
- 마스킹: 하나의
팔의 수
무기와 개입
참가자 그룹 / 팔참가자 그룹 / 팔 |
개입 / 치료개입 / 치료 |
|---|---|
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실험적: 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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활성 비교기: 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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연구는 무엇을 측정합니까?
주요 결과 측정
주요 결과 측정
결과 측정 |
측정값 설명 |
기간 |
|---|---|---|
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Number of participants with new cardiovascular events
기간: From randomization until the first occurrence of a primary outcome event or the end of follow-up, up to 5 years
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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
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2차 결과 측정
2차 결과 측정
결과 측정 |
측정값 설명 |
기간 |
|---|---|---|
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Number of participants with death due to cardiovascular causes
기간: 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 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
기간: 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
기간: 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
기간: 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
기간: 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.
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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 unstable angina with hospitalization
기간: 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.
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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 chronic kidney disease
기간: 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.
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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 atrial fibrillation
기간: 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.
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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 left ventricular hypertrophy
기간: 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 left ventricular hypertrophy, 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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Win ratio for the hierarchical composite outcome
기간: 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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기타 결과 측정
기타 결과 측정
결과 측정 |
측정값 설명 |
기간 |
|---|---|---|
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Long-Term Cardiovascular Outcomes During Extended Follow-up
기간: 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
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공동 작업자 및 조사자
협력자
협력자
수사관
수사관
- 수석 연구원: Hae-Young Lee, MD, PhD, Seoul National University Hospital
연구 기록 날짜
연구 주요 날짜
연구 시작 (추정된)
연구 시작
기본 완료 (추정된)
기본 완료
연구 완료 (추정된)
연구 완료
연구 등록 날짜
최초 제출
최초 제출
QC 기준을 충족하는 최초 제출
QC 기준을 충족하는 최초 제출
처음 게시됨 (실제)
처음 게시됨
연구 기록 업데이트
마지막 업데이트 게시됨 (실제)
마지막 업데이트 게시됨
QC 기준을 충족하는 마지막 업데이트 제출
QC 기준을 충족하는 마지막 업데이트 제출
마지막으로 확인됨
마지막으로 확인됨
추가 정보
이 연구와 관련된 용어
기타 연구 ID 번호
기타 연구 ID 번호
- CUFFLESS
약물 및 장치 정보, 연구 문서
미국 FDA 규제 의약품 연구
미국 FDA 규제 기기 제품 연구
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