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Comparison of Office and Cuffless Ambulatory Blood Pressure-Guided Management in Patients With Hypertension (CUFFLESS)

17 augusti 2026 uppdaterad av: Hae-young Lee, Seoul National University Hospital

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.

Studieöversikt

Studietyp

Interventionell

Inskrivning (Beräknad)

3000

Fas

  • Inte tillämpbar

Kontakter och platser

Det här avsnittet innehåller kontaktuppgifter för dem som genomför studien och information om var denna studie genomförs.

Studiekontakt

Studera Kontakt Backup

  • Namn: Seung-Mok Lee, MD
  • Telefonnummer: 82-10-7185-4340
  • E-post: mokmom@snu.ac.kr

Studieorter

      • Daegu, Sydkorea
        • Kyungpook National University Hospital
        • Kontakt:
      • Seoul, Sydkorea
        • Korea University Anam Hospital
        • Kontakt:
      • Seoul, Sydkorea
        • Korea University Guro Hospital
      • Seoul, Sydkorea
        • Seoul National University Hospital
        • Kontakt:
      • Seoul, Sydkorea
        • The Catholic University of Korea, Seoul St. Mary's Hospital
        • Kontakt:
      • Seoul, Sydkorea
        • Seoul National University Boramae Medical Center
        • Kontakt:
      • Seoul, Sydkorea
        • Kyung Hee University Hospital at Gangdong
        • Kontakt:
    • Gyeonggi-do
      • Seongnam-si, Gyeonggi-do, Sydkorea
        • Seoul National University Bundang Hospital
        • Kontakt:
      • Uijeongbu-si, Gyeonggi-do, Sydkorea
        • The Catholic University of Korea, Uijeongbu ST. Mary's Hospital
        • Kontakt:

Deltagandekriterier

Forskare letar efter personer som passar en viss beskrivning, så kallade behörighetskriterier. Några exempel på dessa kriterier är en persons allmänna hälsotillstånd eller tidigare behandlingar.

Urvalskriterier

Åldrar som är berättigade till studier

  • Vuxen
  • Äldre vuxen

Tar emot friska volontärer

Nej

Beskrivning

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

Det här avsnittet ger detaljer om studieplanen, inklusive hur studien är utformad och vad studien mäter.

Hur är studien utformad?

Designdetaljer

  • Primärt syfte: Behandling
  • Tilldelning: Randomiserad
  • Interventionsmodell: Parallellt uppdrag
  • Maskning: Enda

Vapen och interventioner

Deltagargrupp / Arm
Intervention / Behandling
Experimentell: 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.
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.
Aktiv komparator: Office blood pressure-guided management group
Participants assigned to this group will receive conventional hypertension management guided by office blood pressure measurements.
Participants will receive conventional hypertension management guided by office blood pressure measurements, with a target office systolic blood pressure of <140 mmHg.

Vad mäter studien?

Primära resultatmått

Resultatmått
Åtgärdsbeskrivning
Tidsram
Number of participants with new cardiovascular events
Tidsram: 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.
From randomization until the first occurrence of a primary outcome event or the end of follow-up, up to 5 years

Sekundära resultatmått

Resultatmått
Åtgärdsbeskrivning
Tidsram
Number of participants with death due to cardiovascular causes
Tidsram: 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
Tidsram: 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.
From randomization until the occurrence of the respective outcome or the end of follow-up, up to 5 years
Number of participants with myocardial infarction
Tidsram: 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.
From randomization until the occurrence of the respective outcome or the end of follow-up, up to 5 years
Number of participants with coronary revascularization
Tidsram: 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
Tidsram: 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
Tidsram: 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
Tidsram: 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
Tidsram: 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
Tidsram: 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
Tidsram: 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.
From randomization through the end of follow-up, up to 5 years

Andra resultatmått

Resultatmått
Åtgärdsbeskrivning
Tidsram
Long-Term Cardiovascular Outcomes During Extended Follow-up
Tidsram: 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

Samarbetspartners och utredare

Det är här du hittar personer och organisationer som är involverade i denna studie.

Samarbetspartners

Utredare

  • Huvudutredare: Hae-Young Lee, MD, PhD, Seoul National University Hospital

Studieavstämningsdatum

Dessa datum spårar framstegen för inlämningar av studieposter och sammanfattande resultat till ClinicalTrials.gov. Studieposter och rapporterade resultat granskas av National Library of Medicine (NLM) för att säkerställa att de uppfyller specifika kvalitetskontrollstandarder innan de publiceras på den offentliga webbplatsen.

Studera stora datum

Studiestart (Beräknad)

24 augusti 2026

Primärt slutförande (Beräknad)

31 december 2031

Avslutad studie (Beräknad)

31 december 2036

Studieregistreringsdatum

Först inskickad

11 augusti 2026

Först inskickad som uppfyllde QC-kriterierna

17 augusti 2026

Första postat (Faktisk)

18 augusti 2026

Uppdateringar av studier

Senaste uppdatering publicerad (Faktisk)

18 augusti 2026

Senaste inskickade uppdateringen som uppfyllde QC-kriterierna

17 augusti 2026

Senast verifierad

1 augusti 2026

Mer information

Termer relaterade till denna studie

Ytterligare relevanta MeSH-villkor

Andra studie-ID-nummer

  • CUFFLESS

Läkemedels- och apparatinformation, studiedokument

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