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.
Przegląd badań
Status
Status
Warunki
Warunki
Interwencja / Leczenie
Interwencja / Leczenie
Typ studiów
Typ studiów
Zapisy (Szacowany)
Zapisy
Faza
Faza
- Nie dotyczy
Kontakty i lokalizacje
Kontakt w sprawie studiów
Kontakt w sprawie studiów
- Nazwa: Ji Young Yoon
- Numer telefonu: 82-10-2704-4542
- E-mail: seecross2846@snu.ac.kr
Kopia zapasowa kontaktu do badania
- Nazwa: Seung-Mok Lee, MD
- Numer telefonu: 82-10-7185-4340
- E-mail: mokmom@snu.ac.kr
Lokalizacje studiów
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Daegu, Korea Południowa
- Kyungpook National University Hospital
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Kontakt:
- Jang Hoon Lee, MD, PhD
- Numer telefonu: 82-53-200-6414
- E-mail: ljhmh75@knu.ac.kr
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Seoul, Korea Południowa
- Korea University Anam Hospital
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Kontakt:
- Hyung Joon Joo, MD, PhD
- Numer telefonu: 82-2-2286-1214
- E-mail: drjoohj@gmail.com
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Seoul, Korea Południowa
- Korea University Guro Hospital
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Seoul, Korea Południowa
- Seoul National University Hospital
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Kontakt:
- Hae-Young Lee, MD, PhD
- Numer telefonu: 82-10-4528-6160
- E-mail: hylee612@snu.ac.kr
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Seoul, Korea Południowa
- The Catholic University of Korea, Seoul St. Mary's Hospital
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Kontakt:
- Woo-Baek Chung, MD, PhD
- Numer telefonu: 82-2-2258-1134
- E-mail: peace816@catholic.ac.kr
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Seoul, Korea Południowa
- Seoul National University Boramae Medical Center
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Kontakt:
- Hack-Lyoung Kim, MD, PhD
- Numer telefonu: 82-2-870-3235
- E-mail: khl2876@gmail.com
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Seoul, Korea Południowa
- Kyung Hee University Hospital at Gangdong
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Kontakt:
- Il-Suk Sohn, MD, PhD
- Numer telefonu: 82-10-8772-4662
- E-mail: issohn@khu.ac.kr
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Gyeonggi-do
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Seongnam-si, Gyeonggi-do, Korea Południowa
- Seoul National University Bundang Hospital
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Kontakt:
- Kwang-Il Kim, MD, PhD
- Numer telefonu: 82-31-787-7032
- E-mail: kikim907@gmail.com
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Uijeongbu-si, Gyeonggi-do, Korea Południowa
- The Catholic University of Korea, Uijeongbu ST. Mary's Hospital
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Kontakt:
- Hyo-Suk Ahn, MD, PhD
- Numer telefonu: 82-10-4223-9201
- E-mail: alaco0502@gmail.com
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Kryteria uczestnictwa
Kryteria kwalifikacji
Kryteria kwalifikacji
Wiek uprawniający do nauki
- Dorosły
- Starszy dorosły
Akceptuje zdrowych ochotników
Opis
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
Plan studiów
Jak projektuje się badanie?
Szczegóły projektu
- Główny cel: Leczenie
- Przydział: Randomizowane
- Model interwencyjny: Przydział równoległy
- Maskowanie: Pojedynczy
Liczba ramion
Broń i interwencje
Grupa uczestników / ArmGrupa uczestników / Arm |
Interwencja / LeczenieInterwencja / Leczenie |
|---|---|
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Eksperymentalny: 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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Aktywny 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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Co mierzy badanie?
Podstawowe miary wyniku
Podstawowe miary wyniku
Miara wyniku |
Opis środka |
Ramy czasowe |
|---|---|---|
|
Number of participants with new cardiovascular events
Ramy czasowe: 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
|
Miary wyników drugorzędnych
Miary wyników drugorzędnych
Miara wyniku |
Opis środka |
Ramy czasowe |
|---|---|---|
|
Number of participants with death due to cardiovascular causes
Ramy czasowe: 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
|
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Number of participants with nonfatal stroke
Ramy czasowe: 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
Ramy czasowe: 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
Ramy czasowe: 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
|
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Number of participants with acute decompensated heart failure
Ramy czasowe: 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
Ramy czasowe: 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
Ramy czasowe: 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
Ramy czasowe: 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
Ramy czasowe: 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
Ramy czasowe: 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
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Inne miary wyników
Inne miary wyników
Miara wyniku |
Opis środka |
Ramy czasowe |
|---|---|---|
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Long-Term Cardiovascular Outcomes During Extended Follow-up
Ramy czasowe: 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.
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From randomization through the end of extended follow-up, up to 10 years
|
Współpracownicy i badacze
Sponsor
Sponsor
Współpracownicy
Współpracownicy
Śledczy
Śledczy
- Główny śledczy: Hae-Young Lee, MD, PhD, Seoul National University Hospital
Daty zapisu na studia
Główne daty studiów
Rozpoczęcie studiów (Szacowany)
Rozpoczęcie studiów
Zakończenie podstawowe (Szacowany)
Zakończenie podstawowe
Ukończenie studiów (Szacowany)
Ukończenie studiów
Daty rejestracji na studia
Pierwszy przesłany
Pierwszy przesłany
Pierwszy przesłany, który spełnia kryteria kontroli jakości
Pierwszy przesłany, który spełnia kryteria kontroli jakości
Pierwszy wysłany (Rzeczywisty)
Pierwszy wysłany
Aktualizacje rekordów badań
Ostatnia wysłana aktualizacja (Rzeczywisty)
Ostatnia wysłana aktualizacja
Ostatnia przesłana aktualizacja, która spełniała kryteria kontroli jakości
Ostatnia przesłana aktualizacja, która spełniała kryteria kontroli jakości
Ostatnia weryfikacja
Ostatnia weryfikacja
Więcej informacji
Terminy związane z tym badaniem
Dodatkowe istotne warunki MeSH
Inne numery identyfikacyjne badania
Inne numery identyfikacyjne badania
- CUFFLESS
Informacje o lekach i urządzeniach, dokumenty badawcze
Bada produkt leczniczy regulowany przez amerykańską FDA
Bada produkt urządzenia regulowany przez amerykańską FDA
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