Hypertension Clinical Trial
Official title:
Lowering Blood Pressure in Primary Care in Vienna
The aim of this prospective, randomised, open-label, multicentre clinical trial is to enhance blood pressure control in primary care by introducing a standardised and simplified titration regime with single pill combinations (SPC), comprising an angiotensin receptor blocker, calcium channel blocker and hydrochlorothiazide.
Rationale Hypertension is the single largest contributor to mortality worldwide, accounting
for 13% of deaths globally. Approximately 30% of the adult population suffer from
hypertension and of those diagnosed and treated, only 30-50% have adequately controlled blood
pressure. At present, the importance of hypertension as fundamental risk factors is
inadequately addressed among many patients and physicians.
Design The aim of this prospective, randomised, open-label, multicentre clinical trial is to
enhance blood pressure control in primary care by introducing a standardised and simplified
titration regime with single pill combinations (SPC), comprising an angiotensin receptor
blocker, calcium channel blocker and hydrochlorothiazide.
The trial will randomise 42 family doctors or resident specialists for internal medicine
(enrolling 840 patients with treated or untreated hypertension) to either experimental care
or standard care for hypertension, latter according to the 2013 European Society of
Cardiology Guidelines for the Management of Arterial Hypertension.
Practitioners randomised to experimental care will up-titrate antihypertensive therapy with
SPCs in 4-week intervals if the target blood pressure of < 140/90 mmHg is not reached at the
respective follow-up (Figure 1).
Study Outcomes The primary efficacy endpoint will be the proportion of patients achieving the
target office blood pressure after 6 months of follow-up. The main secondary endpoint will be
the improvement of 24h ambulatory blood pressure (ABPM) profile, measured at inclusion and
after 6 months of follow-up.
Safety assessments include the evaluation of treatment emergent adverse events, particularly
hospitalisation, worsening of renal function, peripheral oedema and hypotension.
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