View clinical trials related to Hypertension.
Filter by:The present study is a single-centre prospective study that will enrol pregnant women during their first trimester of pregnancy (11+0 - 13+6 weeks of gestation). During pregnancy, women will undergo standard clinical evaluation and management. During the two study visits (enrollment and 24+0 - 27+6 weeks of gestation) the investigators will perform arterial tonometry (Pulsepen) and in vivo darkfield microscopy (Glycocheck) to evaluate endothelial and vascular function. A urine sample and a blood sample for specific study analyses on metabolic profile, endothelial and angiogenic markers will be collected. Pregnancy outcomes will be collected at delivery and five years after delivery all the participants will be interview to collect long-term cardiovascular outcomes. Serum endothelial and angiogenic markers will be evaluated only in participants who will develop hypertensive disorders of pregnancy and in an equal number of controls matched for age and body mass index at the time of conception.
This study aims to develop, implement, and determines the effectiveness of a personalized medicine approach to each individual's phenotype, based on an innovative physical exercise program to promote the treatment of pain and functional limitation resulting from knee osteoarthritis (KOA) in patients recovering after acute myocardial infarction (AMI) and cardiovascular risk (CVR). This randomized clinical study is important due to the lack of evidence according to the effectiveness of a personalized physical exercise intervention in people after MI or CVR with simultaneous KOA. Some studies have shown the existence of a relationship between OA and cardiovascular diseases (CVD), including coronary artery disease, stroke, congestive heart failure, peripheral arterial disease, cardiac procedures, or death related to CVD, since individuals with OA have a higher prevalence of CVD than individuals without OA. Sedentary behaviour is a risk factor for AMI, CVR and KOA, and, at the same time, physical exercise is a common non-pharmacological treatment for people suffering from these conditions, namely in the control of joint pain, gains in functional capacity, and the improvement of cardiorespiratory functional capacity, whose impact can be felt in level of quality of life. Chronic diseases have a significant impact on the global burden of disease, particularly CVD and OA, with the added presence of obesity also contributing to a high rate of all-cause morbidity and mortality, representing a substantial health burden and with growing implications for individuals, health systems and socioeconomic costs. The presence of OA seems to lead to an increased risk of developing CVD. Several mechanisms have been proposed to explain this relationship. Chronic inflammation associated with OA is one of the hypotheses suggested to explain the increased risk of CVD in these individuals. Furthermore, the pain and disability associated with OA may also limit participation in exercise/physical activity, influencing other risk factors associated with both chronic diseases, such as weight gain. The lack of studies about physical exercise intervention on people that suffered acute myocardial infarction or is in cardiovascular risk with simultaneous knee osteoarthritis and the lack of offer of phase III cardiac rehabilitation in Algarve motivated the development of this study, with the assumption of adopting a healthier lifestyle.
This is a single-center, double blind, randomized, parallel-arms study designed to investigate the effects of a six-month treatment with the SGLT2i dapagliflozin on markers of kidney senescence, inflammation and tubulointerstitial damage compared to placebo. These mechanisms of renal damage will be investigated in proximal tubular epithelial cells (PTECs) isolated from urine from patients with CKD with or without T2DM and in renal biopsy specimens in a subgroup of patients with diabetic kidney disease.
The goal of this interventional study is to compare improved outcomes among diabetes and/or hypertensive patients sequel to educational intervention. The study aims to answer the following questions: - What are the patients' levels of health literacy, medication adherence, disease knowledge, attitude to disease, physical activity? - Does educational intervention by pharmacists improve health outcomes of patients with diabetes and/or hypertension? - Are there associations between patient-related variables such as health literacy, medication adherence, disease knowledge, attitude to disease? Participants' anthropometric measurements and point-of-care testing for disease monitoring e.g., blood pressure, blood glucose would be carried out. Baseline assessment of participants would be done to evaluate their levels of health literacy, medication adherence, disease knowledge, attitude to disease, physical activity. Patients' baseline assessment would be carried out, after which they would receive educational materials and would be followed up by pharmacist. The baseline assessments would be repeated at three and six months after the intervention to measure the effectiveness of the intervention.
The goal of this pilot study is to evaluate the safety and efficacy of pulmonary artery denervation (PADN) in combined post- and pre- capillary pulmonary hypertension (CpcPH) associated with chronic heart failure(CHF). Participants who have received guideline-directed medical therapy (GDMT) according to 2022 AHA/ACC Guidelines for Heart Failure (HF) and have been clinically stable for at least 1 month, will be treated with PADN and followed for 1 year.
To study the effect of relocation from 2840m (Quito) to sea level (Pedernales) in patients with pulmonary vascular diseases (PVD) defined as pulmonary arterial hypertension or chronic thromboembolic pulmonary hypertension (PH) who permanently live >2500m on 6-minute walk distance (6MWD)
Although hypertension is an important cause of premature death, it can increase the risk of heart, brain, kidney and other diseases. Worldwide, 1 in 4 men and 1 in 5 women (over a billion people) have this condition (https://www.who.int/health-topics/hypertension#tab=tab_1 4 July 2022). The prevalence of hypertension in Turkey was determined as 32.3% in women, 28.4% in men and 30.3% in general, according to the Turkish Hypertension Prevalence (PatenT2) study (Sengul et al. 2016). Although the exact cause of hypertension is not clear, age, family history, eating habits, smoking-alcohol intake, weight and physical activity level have a strong influence on blood pressure. Hypertension management is normally easy through regular use of antihypertensive drugs and adherence to lifestyle interventions (https://world-heart-federation.org/what-we-do/hypertension/ 4 July 2022). As a matter of fact, it is stated in the World Health Organization (WHO) hypertension guideline that healthy lifestyle behaviors should be considered together with antihypertensive drugs (WHO 2021). The recommended healthy lifestyle behaviors for the prevention and control of hypertension are reducing salt consumption, high potassium intake, healthy diet, fighting obesity, regular physical activity and reducing cigarette-alcohol consumption (Mills et al. 2020). Despite the availability and high prevalence of treatment for hypertension, less than 1 in 5 people worldwide have it under control (https://www.who.int/news-room/fact-sheets/detail/hypertension 4 July 2022). In Turkey, an estimated 49.1% of adults with hypertension are unaware that they have this condition. However, less than half (46.2%) of adults with hypertension are treated and approximately 1 in 5 adults (23.9%) have it under control(https://www.who.int/publications/m/item/hypertension-tur-country-profile-turkey-2020 4 July 2022) . Although the nutritional, behavioral, and environmental causes of hypertension are well established, little is known about what actions and interventions are responsible for the low rates of awareness, treatment, and control (Zhou et al. 2021). Therefore, the development of new approaches to improve the prevention, management and control of hypertension has come to the fore(Özpulat 2017; Karmakar et al. 2018). The Turkish Hypertension Consensus report recommended that "tele-medicine" applications should be started to be used for blood pressure control and drug compliance with the advancing technology (https://fka.gov.tr/kalkinma-planlari-detayi-1564726568912 17 August 2022). Hypertension management guideline published by the Japanese Hypertension Society (JSH)-2019 explains that digital hypertension management can be facilitated using health information technology (Kario 2019). According to the International Council of Nurses (ICN), team-based care (especially virtual care) empowered through technology can respond to the change sought in healthcare delivery (ICN 2021). Likewise, WHO stated that using mobile health technologies creates important opportunities to reduce premature deaths from non-communicable diseases (WHO 2018). Mobile health technology mainly focuses on the use of mass media such as mobile phone-based or connected interventions (Gandapur et al. 2016; Karmakar et al. 2018). The near ubiquity, mobility, and direct and instantaneous nature of mobile phones and other mobile devices have enormous potential to impact healthcare delivery and health outcomes (White et al. 2016; Morawski et al. 2017; Gong et al. 2020). In the meta-analysis, it was seen that mobile health applications have a beneficial effect in health interventions to create behavior change (Iribarren et al. 2021). Another meta-analysis showed that messages given in behavior change interventions, including reducing salt intake in food, increasing physical activity, quitting smoking, increasing consumption of low-fat diet and fruit and vegetables, resulted in a significant reduction in blood pressure, in particular (Saif-Ur-Rahman et al. 2019). In our study, the Protection Motivation Theory (KMT) will be used together with the use of mobile phones in creating behavior change. KMT is a common framework describing the use of protective behaviors and can be applied to interventions designed to change behavior (Rogers 1983). In this context, this study aims to evaluate the effects of nursing interventions including mobile phone use and patient education based on CMT on drug compliance and healthy lifestyle behaviors in hypertensive patients.
Objectives: We have developed a cardiovascular disease management application named Heart4U, with the capability of integrating with the Electronic Medical Records (EMR) system within the hospital. The main goal of this study is to evaluate the clinical effectiveness of a treatment approach that entails self-management of risk factors through a mobile application among pregnant individuals diagnosed with hypertensive cardiovascular conditions. Methods: Patients assigned to the app group receive assistance from the research team to install the Heart4U application and familiarize themselves with its usage. Both the app group and the usual care group continue to receive active treatment as previously administered (guideline-based prenatal care). Follow-up observations occur at each obstetric examination prior to delivery and are conducted again at the first month postpartum. The primary endpoint of observation pertains to the difference in systolic blood pressure between the enrollment and study completion time points.
To evaluate the impact of home blood pressure monitoring when used in addition to pharmacist care, compared to usual care, in women with elevated blood pressure (BP). Randomized 1:1 two-arm controlled trial. Patients to be identified and screened by pharmacists. Patients with a BP >140/90mmHg or >130/80mmHg in those with diabetes will be invited to enroll in the study. Intervention: Patients will have BP assessed at baseline by the pharmacist, and they will receive a home blood pressure monitor in addition to counselling provided by the pharmacist. Patients will measure their BP at home for seven days every four weeks and input their results into a data management system. The pharmacist will follow up with the patient every 4 weeks to review their readings and at 24-weeks the patient will come into the pharmacy for a final follow-up and BP readings. The pharmacist will fax BP readings and suggestions for therapy modification to the patient's prescribing clinician. After 24-weeks patient care is returned to the prescribing clinician with no further pharmacist interventions except for a final post-trial follow-up at week-52 to review ongoing home BP monitor use and BP management by the prescribing clinician. Control: Patients will have BP assessed at baseline, 12-, and 24-weeks in the pharmacy by the pharmacist. Patients will not receive a home blood pressure monitor. Pharmacist will provide usual care, education and counselling on BP management. Pharmacists will fax BP readings to the patient's prescribing clinician but will not provide any suggestions for therapy modification. After 24-weeks patients will be offered a home blood pressure monitor with education on its use. They will then be offered to crossover to the intervention group for the next 24-weeks or have their care returned to their prescribing clinician with no pharmacist specific interventions except for a final post-trial follow-up at week-52 to review ongoing home BP monitor use and BP management by the prescribing clinician. Sample Size: Calculated sample size is 368 participants to achieve 80% power, with 184 patients in the intervention and control groups. Primary Outcome: Difference in change in Systolic Blood Pressure between the home blood pressure monitoring in addition to pharmacist care versus usual care group.
In Tunisia, high blood pressure (HTN) is a public health problem whose prevalence varies from 28.7% to 34.7%. Hypertension can be both, cause and consequence of chronic kidney disease, and its prevalence is quite high in this population. It is both a risk factor for mortality and cardiovascular morbidity, but also a major cause of terminal chronic kidney disease becoming an additional public health concern. Detecting and diagnosing chronic kidney in all hypertensives at an early stage remains a global public health challenge. A well-conducted treatment makes it possible to reach the blood pressure objective but also to reduce the risk of occurrence of a cardiovascular event and to slow the progression of chronic kidney disease. In Tunisia, few data exists concerning the prevalence of chronic kidney disease in hypertensive subjects, thus limiting the development and elaboration of preventive measures. A national survey will thus be conducted by the "Kidney and Metabolic Diseases" Working Group under the aegis of the Tunisian Society of Nephrology, Dialysis and Kidney Transplantation. The main objective is to estimate the prevalence of chronic kidney disease in hypertensive tunisian patients.