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.
Обзор исследования
Статус
Статус
Условия
Условия
Вмешательство/лечение
Вмешательство/лечение
Тип исследования
Тип исследования
Регистрация (Оцененный)
Регистрация
Фаза
Фаза
- Непригодный
Контакты и местонахождение
Контакты исследования
Контакты исследования
- Имя: Ji Young Yoon
- Номер телефона: 82-10-2704-4542
- Электронная почта: seecross2846@snu.ac.kr
Учебное резервное копирование контактов
- Имя: Seung-Mok Lee, MD
- Номер телефона: 82-10-7185-4340
- Электронная почта: mokmom@snu.ac.kr
Места учебы
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Daegu, Южная Корея
- Kyungpook National University Hospital
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Контакт:
- Jang Hoon Lee, MD, PhD
- Номер телефона: 82-53-200-6414
- Электронная почта: ljhmh75@knu.ac.kr
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Seoul, Южная Корея
- Korea University Anam Hospital
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Контакт:
- Hyung Joon Joo, MD, PhD
- Номер телефона: 82-2-2286-1214
- Электронная почта: drjoohj@gmail.com
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Seoul, Южная Корея
- Korea University Guro Hospital
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Seoul, Южная Корея
- Seoul National University Hospital
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Контакт:
- Hae-Young Lee, MD, PhD
- Номер телефона: 82-10-4528-6160
- Электронная почта: hylee612@snu.ac.kr
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Seoul, Южная Корея
- The Catholic University of Korea, Seoul St. Mary's Hospital
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Контакт:
- Woo-Baek Chung, MD, PhD
- Номер телефона: 82-2-2258-1134
- Электронная почта: peace816@catholic.ac.kr
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Seoul, Южная Корея
- Seoul National University Boramae Medical Center
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Контакт:
- Hack-Lyoung Kim, MD, PhD
- Номер телефона: 82-2-870-3235
- Электронная почта: khl2876@gmail.com
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Seoul, Южная Корея
- Kyung Hee University Hospital at Gangdong
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Контакт:
- Il-Suk Sohn, MD, PhD
- Номер телефона: 82-10-8772-4662
- Электронная почта: issohn@khu.ac.kr
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Gyeonggi-do
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Seongnam-si, Gyeonggi-do, Южная Корея
- Seoul National University Bundang Hospital
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Контакт:
- Kwang-Il Kim, MD, PhD
- Номер телефона: 82-31-787-7032
- Электронная почта: kikim907@gmail.com
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Uijeongbu-si, Gyeonggi-do, Южная Корея
- The Catholic University of Korea, Uijeongbu ST. Mary's Hospital
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Контакт:
- Hyo-Suk Ahn, MD, PhD
- Номер телефона: 82-10-4223-9201
- Электронная почта: alaco0502@gmail.com
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Критерии участия
Критерии приемлемости
Критерии приемлемости
Возраст, подходящий для обучения
- Взрослый
- Пожилой взрослый
Принимает здоровых добровольцев
Описание
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
Учебный план
Как устроено исследование?
Детали дизайна
- Основная цель: Уход
- Распределение: Рандомизированный
- Интервенционная модель: Параллельное назначение
- Маскировка: Одинокий
Количество рук
Оружие и интервенции
Группа участников / АрмияГруппа участников / Армия |
Вмешательство/лечениеВмешательство/лечение |
|---|---|
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Экспериментальный: 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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Активный компаратор: 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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Что измеряет исследование?
Первичные показатели результатов
Первичные показатели результатов
Мера результата |
Мера Описание |
Временное ограничение |
|---|---|---|
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Number of participants with new cardiovascular events
Временное ограничение: 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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Вторичные показатели результатов
Вторичные показатели результатов
Мера результата |
Мера Описание |
Временное ограничение |
|---|---|---|
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Number of participants with death due to cardiovascular causes
Временное ограничение: 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
Временное ограничение: 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
Временное ограничение: 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
Временное ограничение: 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
Временное ограничение: 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
Временное ограничение: 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
Временное ограничение: 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
Временное ограничение: 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
Временное ограничение: 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.
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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
Временное ограничение: 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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Другие показатели результатов
Другие показатели результатов
Мера результата |
Мера Описание |
Временное ограничение |
|---|---|---|
|
Long-Term Cardiovascular Outcomes During Extended Follow-up
Временное ограничение: 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
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Соавторы и исследователи
Спонсор
Спонсор
Соавторы
Соавторы
Следователи
Следователи
- Главный следователь: Hae-Young Lee, MD, PhD, Seoul National University Hospital
Даты записи исследования
Изучение основных дат
Начало исследования (Оцененный)
Начало исследования
Первичное завершение (Оцененный)
Первичное завершение
Завершение исследования (Оцененный)
Завершение исследования
Даты регистрации исследования
Первый отправленный
Первый отправленный
Впервые представлено, что соответствует критериям контроля качества
Впервые представлено, что соответствует критериям контроля качества
Первый опубликованный (Действительный)
Первый опубликованный
Обновления учебных записей
Последнее опубликованное обновление (Действительный)
Последнее опубликованное обновление
Последнее отправленное обновление, отвечающее критериям контроля качества
Последнее отправленное обновление, отвечающее критериям контроля качества
Последняя проверка
Последняя проверка
Дополнительная информация
Термины, связанные с этим исследованием
Дополнительные соответствующие термины MeSH
Другие идентификационные номера исследования
Другие идентификационные номера исследования
- CUFFLESS
Информация о лекарствах и устройствах, исследовательские документы
Изучает лекарственный продукт, регулируемый FDA США.
Изучает продукт устройства, регулируемый Управлением по санитарному надзору за качеством пищевых продуктов и медикаментов США.
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