Hypertension Clinical Trial
Official title:
Randomized Preventive Vascular Screening Trial of 65-74 Year Old Men in the Central Region of Denmark
Well-documented health benefits may be achieved through prophylactic screening for
cardiovascular disease. The advantages are fewer premature deaths and a reduction in the
number of hospital admissions and amputations. Furthermore, hospitals will benefit from the
derived reduction in the pressure on surgery and intensive care capacities at vascular
surgery departments.
It therefore seems extremely relevant to offer joint screening for abdominal aortic
aneurysm, peripheral arterial disease and hypertension, even if the benefit and costs of
such a measure are not currently known.
Consequently, the primary objective of the study is to establish the effect and
cost-efficiency of a joint circulation screening programme for 40,000 men aged 65-74 years
in a randomised, clinically controlled study.
The project manager will train six nurses to measure ABI and perform ultrasound scans of the
aorta. The nurses form three teams which will each be equipped with a portable Doppler,
blood pressure cuff and portable ultrasound scanner. Each team will operate from the
hospitals in the Region. Civil registration number (in Danish: CPR), name and address
information will be supplied by the Clinical Epidemiological Department (CED), which will
also perform the randomisation in groups of approx. 1,000 to avoid too long a period from
data extraction to invitation. Half of the randomised subjects will be invited to
participate in a circulation examination focused on PAD, AAA and hypertension, while the
other half will be controls Men with positive findings are informed and proper preventive
actions is taken. Annual controls are offered, and AAA exceeding 5.5 cm in diameter is
offered operation.
The primary efficiency variables are death, cardiovascular death and AAA-death. The
secondary efficiency variables are hospital services related to cardiovascular conditions
and costs for such services in accordance with current DRG rates.
The entire population, the controls as well as the screening group, will be monitored for a
period of 10 years. Information concerning deaths, including date of death, is obtained from
the Civil Registration System, information on visits to outpatient clinics and hospital
admissions caused by cardiovascular conditions including amputations is obtained from the
National Patient Registry. From the Danish Causes of Death Registry information on cause of
death is collected. The information is classified with regards to cause; AAA or
cardiovascular. The cardiovascular interventions are identified in the vascular surgery
database (Karbasen). Major follow-up is performed at 3, 5 and 10 years.
A steering and data validation group will be formed including the project manager and a
representative from the Clinical Epidemiology Department. Furthermore, a vascular surgeon
from each of the two affected departments in the region will participate.
Total mortality, cardiovascular and AAA-related mortality and initial cardiovascular
hospital service are compared for the two groups using Cox proportional hazards-regression
analysis which facilitates description of the risk ratio. The cost-efficiency calculation
will be adjusted for quality of life.
Status | Recruiting |
Enrollment | 40000 |
Est. completion date | December 2023 |
Est. primary completion date | September 2018 |
Accepts healthy volunteers | No |
Gender | Male |
Age group | 65 Years to 74 Years |
Eligibility |
Inclusion Criteria: - men aged 65-74 years old living in the central region of Denmark Exclusion Criteria: - men not aged 65-74 years - men aged 65-74 years old not living in the central region of Denmark |
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Single Blind (Investigator), Primary Purpose: Screening
Country | Name | City | State |
---|---|---|---|
Denmark | Vascular Research Unit, Dept. of Vasc. Surgery, Viborg Hospital | Viborg |
Lead Sponsor | Collaborator |
---|---|
Central Jutland Regional Hospital | Aarhus University Hospital |
Denmark,
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Primary | All cause mortality | 3, 5, and 10 years | No | |
Secondary | Cardiovascular events | 3,5 and 10 years | No |
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