Heart Rate Variability and Medication Adherence in Resistant Hypertension (HRV-HYP-1)
2026年7月13日 更新者：Matej Pekar, MD, PhD、Nemocnice AGEL Trinec-Podlesi a.s.
Eart Rate Variability, Medication Adherence, and Blood Pressure Control in Resistant Hypertension: A Cross-Sectional Study
This single-center, cross-sectional observational study examines the relationship between adherence to antihypertensive therapy - verified objectively by therapeutic drug monitoring (TDM) - and heart rate variability (HRV) in patients with resistant hypertension.
Patients are recruited opportunistically, in a nurse-led manner, in a one-day-care cardiology unit, and undergo a single examination: a short-term HRV recording (Polar H10), a single blood draw for antihypertensive drug levels, office blood pressure, and self-completed questionnaires.
There is no follow-up.
研究概览
地位
尚未招聘
详细说明
Non-adherence to antihypertensive medication is a major cause of apparently resistant hypertension and confounds interpretation of autonomic measures.
HRV is a non-invasive index of autonomic cardiac regulation and is systematically influenced by antihypertensive drugs.
The study tests whether TDM-verified intake of antihypertensives is reflected in HRV parameters, and whether HRV can serve as a complementary marker of adherence.
Adherence is determined by TDM (the objective gold standard); a self-report questionnaire (MARS-CZ) is collected as a secondary, descriptive measure.
HRV is recorded for 10-15 minutes seated, before sedation and before heparin/contrast; the blood sample is drawn before heparin/contrast, with the time of last dose recorded.
Time-domain (SDNN, RMSSD, pNN50) and frequency-domain (LF, HF, LF/HF) HRV parameters are analysed.
Approximately 100-200 patients are planned for enrolment.
It does not interfere with the patient's planned cardiac procedure; the one-day-care unit is the recruitment venue only.
研究类型
观察性的
注册 (估计的)
150
联系人和位置
本节提供了进行研究的人员的详细联系信息，以及有关进行该研究的地点的信息。
学习联系方式
- 姓名：Jan Alexander Mohr, MD
- 电话号码：+420724173927
- 邮箱：jan.mohr@npo.agel.cz
学习地点
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Moravian-Silesian Region
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Třinec、Moravian-Silesian Region、捷克语、739 61
- Nemocnice AGEL Třinec-Podlesí a.s.
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接触：
- Jan Alexander Mohr, MD
- 电话号码：+420 724 173 927
- 邮箱：jan.mohr@npo.agel.cz
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-
参与标准
研究人员寻找符合特定描述的人，称为资格标准。这些标准的一些例子是一个人的一般健康状况或先前的治疗。
资格标准
适合学习的年龄
- 成人
- 年长者
接受健康志愿者
不
取样方法
非概率样本
研究人群
Adults (18-75 years) with essential hypertension treated with at least three antihypertensive drugs of different classes, including at least one diuretic (resistant hypertension), and in sinus rhythm.
Participants are identified and recruited opportunistically, in a nurse-led manner, among patients attending a one-day-care cardiology unit at a single center.
描述
Inclusion Criteria:
- Age 18-75 years with diagnosed essential hypertension
- Treated with ≥3 antihypertensive drugs of different classes, including ≥1 diuretic (resistant hypertension)
- Sinus rhythm
- Able to give informed consent and understand Czech
Exclusion Criteria:
- Absence of sinus rhythm: atrial fibrillation/flutter, ventricular arrhythmias, higher-degree AV block, pacemaker/ICD with sustained pacing, sustained SVT, or significant ectopy
- Secondary hypertension
- Pregnancy or breastfeeding
- Cognitive impairment precluding informed consent
学习计划
本节提供研究计划的详细信息，包括研究的设计方式和研究的衡量标准。
研究是如何设计的？
设计细节
队列和干预
团体/队列 |
干预/治疗 |
|---|---|
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Resistant hypertension (≥3 antihypertensives incl. diuretic, sinus rhythm)
Single cohort analysed by adherence status defined by TDM: adherent vs non-adherent.
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Short-term (10-15 min) seated HRV; time-domain (SDNN, RMSSD, pNN50) and frequency-domain (LF, HF, LF/HF) parameters.
Single blood draw measuring antihypertensive drug levels; defines adherent vs non-adherent status.
Self-completed instruments assessing medication adherence, mood, quality of life, and physical activity.
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研究衡量的是什么？
主要结果指标
结果测量 |
措施说明 |
大体时间 |
|---|---|---|
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Heart rate variability parameters by TDM-defined adherence
大体时间：At the single study visit (Day 1)
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Time-domain (SDNN, RMSSD, pNN50) and frequency-domain (LF, HF, LF/HF ratio) HRV parameters from a short-term seated recording, compared between TDM-adherent and TDM-non-adherent patients.
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At the single study visit (Day 1)
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次要结果测量
结果测量 |
措施说明 |
大体时间 |
|---|---|---|
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Heart rate variability in relation to office blood-pressure control
大体时间：At the single study visit (Day 1)
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Association between HRV parameters and office blood pressure measured seated immediately before the HRV recording.
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At the single study visit (Day 1)
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Questionnaire scores in relation to adherence and HRV
大体时间：At the single study visit (Day 1)
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Scores of MARS-CZ (adherence), PHQ-9 (mood), SF-36 (quality of life), and IPAQ (physical activity) examined against TDM-defined adherence and HRV parameters.
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At the single study visit (Day 1)
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Prevalence of non-adherence by therapeutic drug monitoring
大体时间：At the single study visit (Day 1)
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Proportion of patients classified as non-adherent to antihypertensive therapy based on TDM (absent or subtherapeutic drug levels).
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At the single study visit (Day 1)
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合作者和调查者
在这里您可以找到参与这项研究的人员和组织。
调查人员
- 首席研究员：Jan Alexander Mohr, MD、Nemocnice AGEL Třinec-Podlesí a.s.
- 研究主任：Matej Pekar, MD, PhD、Nemocnice AGEL Třinec-Podlesí a.s.
出版物和有用的链接
负责输入研究信息的人员自愿提供这些出版物。这些可能与研究有关。
一般刊物
- Heart rate variability: standards of measurement, physiological interpretation and clinical use. Task Force of the European Society of Cardiology and the North American Society of Pacing and Electrophysiology. Circulation. 1996 Mar 1;93(5):1043-65. No abstract available.
- Ladova K, Matoulkova P, Zadak Z, Macek K, Vyroubal P, Vlcek J, Morisky DE. Self-reported adherence by MARS-CZ reflects LDL cholesterol goal achievement among statin users: validation study in the Czech Republic. J Eval Clin Pract. 2014 Oct;20(5):671-7. doi: 10.1111/jep.12201. Epub 2014 Jun 11.
研究记录日期
这些日期跟踪向 ClinicalTrials.gov 提交研究记录和摘要结果的进度。研究记录和报告的结果由国家医学图书馆 (NLM) 审查，以确保它们在发布到公共网站之前符合特定的质量控制标准。
研究主要日期
学习开始 (估计的)
2026年7月20日
初级完成 (估计的)
2027年7月20日
研究完成 (估计的)
2027年12月31日
研究注册日期
首次提交
2026年7月13日
首先提交符合 QC 标准的
2026年7月13日
首次发布 (实际的)
2026年7月16日
研究记录更新
最后更新发布 (实际的)
2026年7月16日
上次提交的符合 QC 标准的更新
2026年7月13日
最后验证
2026年7月1日
更多信息
与本研究相关的术语
其他相关的 MeSH 术语
其他研究编号
- HRV-HYP-1
- EK 29/25 (其他标识符：Ethics Committee, AGEL Třinec-Podlesí Hospital)
计划个人参与者数据 (IPD)
计划共享个人参与者数据 (IPD)？
未定
药物和器械信息、研究文件
研究美国 FDA 监管的药品
不
研究美国 FDA 监管的设备产品
不
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