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Clinical Trial Details — Status: Terminated

Administrative data

NCT number NCT04467879
Other study ID # 001
Secondary ID
Status Terminated
Phase N/A
First received
Last updated
Start date June 1, 2020
Est. completion date September 14, 2022

Study information

Verified date September 2022
Source Zona Health, Inc
Contact n/a
Is FDA regulated No
Health authority
Study type Interventional

Clinical Trial Summary

This is a double-blind, sham-controlled clinical trial assessing the effectiveness of personalized isometric handgrip device therapy. Approximately 230 patients who present with a Systolic Blood Pressure reading of ≤ 149mmHg and who have not taken any antihypertensive medication for more than 30 days will be enrolled.


Description:

This study is designed to examine the effectiveness of individualized isometric handgrip device therapy in prehypertension or hypertension patient subjects who are not at target BP and who are naive to anti-hypertensive medication for at least 30 days before screening. The investigational plan examines changes in blood pressure (BP) in up to 230 patient subjects who are randomized to either the "active" (i.e., the Zona Plus device proposed for marketing), or to a "sham" device (which is intentionally calibrated for a "weaker grip").


Recruitment information / eligibility

Status Terminated
Enrollment 146
Est. completion date September 14, 2022
Est. primary completion date September 13, 2022
Accepts healthy volunteers No
Gender All
Age group 18 Years to 80 Years
Eligibility Inclusion Criteria - Male or female of any ethnicity between 18 and 80 years of age - Diagnosed with prehypertension or hypertension and verified during the Baseline visit - Non-use of antihypertensive medication for =30 prior to screening - Currently not taking any antihypertensive medications or decline to take any antihypertensive medications(e.g., diuretic, angiotensin-converting enzyme inhibitor (ACEI), angiotensin II receptor blocker (ARB), ] beta-blocker (BB), renin inhibitor (RI), calcium channel blocker (CCB) or alpha-adrenergic agonist (clonidine)) - Sufficient vision with the patient able to see the screen prompts on the device, sufficient hearing with the patient able to hear the device audio prompts, sufficient hand strength (demonstrated by a maximum voluntary contraction equaling 35 units of force in both hands measured by the device) - Baseline Blood Pressure measurements collected and study device training completed during the Baseline visit - Non-use of medications and over the counter (OTC)supplement regimen related to hypertension throughout the study duration - Only one patient per household can participate in the study, eliminating the potential of unblinding - Able to comply with study procedures and agrees to complete all required study visits and associated activities - Ability to give written informed consent in either English, Spanish or French •=149 mmHg, Systolic Blood Pressure wherein patients who present with Systolic Blood Pressure readings =140 mmHg will receive heightened monitoring throughout the first month of the study Exclusion Criteria - Pregnant or not using adequate contraception - Blood Pressure =150 mmHg (systolic) and/or >90 mmHg (diastolic) - History of heart failure - Hospitalization due to a hypertensive emergency, with impending or progressive target organ dysfunction (i.e., renal dysfunction, left ventricular hypertrophy or CNS involvement) within the past six (6) months •>10 mmHg difference in Systolic Blood Pressure between the right and left arms collected during screening - Unstable Blood Pressure, defined as >5 mmHg variance between any two (2) consecutive weekly readings (with a maximum of four (4) attempts) to determine a baseline BP measurement - Arm circumference greater than 45cm - Acute illness, infection, or inflammation - Unstable cardiovascular disorder, such as MI, unstable angina, significant arrhythmia, stroke, or TIA within the last six (6)months, or other serious comorbidity impacting life expectancy to < than a 1 year - Rest or exertional angina pectoris in the previous six (6) months - History of solid organ transplant - Secondary form of hypertension (HTN) etiology, including but not limited to primary aldosteronism, chronic steroid therapy and Cushing syndrome, pheochromocytoma, aorta coarctation or untreated thyroid or parathyroid disease - Concurrent participation in an investigational clinical study that has not completed the follow-up period or planned participation in another study within the next six(6) months - Any condition or personal circumstance that, in the judgment of the investigator, might interfere with the collection of complete, good quality data or the completion of the research study - Currently own or have owned another Zona Plus device and are,or have been,voluntarily performing the isometric handgrip activities.

Study Design


Related Conditions & MeSH terms


Intervention

Device:
Zona Plus Device
Zona Plus 3.0 Individualized Isometric Handgrip Therapy Device
Control Device
Zona Plus control sham device, with a nominal weaker grip

Locations

Country Name City State
United States Carolinas Research Center LLC Charlotte North Carolina
United States Goldsboro Medical Center Goldsboro North Carolina
United States Sante Clinical Research Kerrville Texas
United States Saint Louis Heart & Vascular, P.C. Saint Louis Missouri
United States Sun Research Institute San Antonio Texas

Sponsors (2)

Lead Sponsor Collaborator
Zona Health, Inc Research & Development Concierge Company

Country where clinical trial is conducted

United States, 

References & Publications (48)

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Gasowski J, Staessen JA, Celis H, Fagard RH, Thijs L, Birkenhäger WH, Bulpitt CJ, Fletcher AE, Arabidze GG, de Leeuw P, Dollery CT, Duggan J, Kawecka-Jaszcz K, Leonetti G, Nachev C, Safar M, Rodico JL, Rosenfeld J, Seux ML, Tuomilehto J, Webster J, Yodfat Y. Systolic Hypertension in Europe (Syst-Eur) trial phase 2: objectives, protocol, and initial progress. Systolic Hypertension in Europe Investigators. J Hum Hypertens. 1999 Feb;13(2):135-45. — View Citation

Gibbons RJ, Balady GJ, Bricker JT, Chaitman BR, Fletcher GF, Froelicher VF, Mark DB, McCallister BD, Mooss AN, O'Reilly MG, Winters WL Jr, Gibbons RJ, Antman EM, Alpert JS, Faxon DP, Fuster V, Gregoratos G, Hiratzka LF, Jacobs AK, Russell RO, Smith SC Jr; American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee to Update the 1997 Exercise Testing Guidelines). ACC/AHA 2002 guideline update for exercise testing: summary article: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee to Update the 1997 Exercise Testing Guidelines). Circulation. 2002 Oct 1;106(14):1883-92. — View Citation

Grucza R, Kahn JF, Cybulski G, Niewiadomski W, Stupnicka E, Nazar K. Cardiovascular and sympatho-adrenal responses to static handgrip performed with one and two hands. Eur J Appl Physiol Occup Physiol. 1989;59(3):184-8. — View Citation

Hansson L, Zanchetti A, Carruthers SG, Dahlöf B, Elmfeldt D, Julius S, Ménard J, Rahn KH, Wedel H, Westerling S. Effects of intensive blood-pressure lowering and low-dose aspirin in patients with hypertension: principal results of the Hypertension Optimal Treatment (HOT) randomised trial. HOT Study Group. Lancet. 1998 Jun 13;351(9118):1755-62. — View Citation

Hicks KA, Hung HMJ, Mahaffey KW, et al.

Howden R, Lightfoot JT, Brown SJ, Swaine IL. The effects of isometric exercise training on resting blood pressure and orthostatic tolerance in humans. Exp Physiol. 2002 Jul;87(4):507-15. — View Citation

Hurst JW, Morris DC, Alexander RW. The use of the New York Heart Association's classification of cardiovascular disease as part of the patient's complete Problem List. Clin Cardiol. 1999 Jun;22(6):385-90. — View Citation

ICH Steering Committee. Draft ICH Consensus Principle:Principles for ClinicalEvaluation ofNew Antihypertensive Drugs. International Conference onHarmonisation ofTechnical Requirements for Registration of Pharmaceuticals forHuman Use. 2000.http://www.fda.gov/downloads/Drugs/GuidanceComplianceRegulatoryInformation/Guidances/ucm073147.pdf

Julius S, Kjeldsen SE, Weber M, Brunner HR, Ekman S, Hansson L, Hua T, Laragh J, McInnes GT, Mitchell L, Plat F, Schork A, Smith B, Zanchetti A; VALUE trial group. Outcomes in hypertensive patients at high cardiovascular risk treated with regimens based on valsartan or amlodipine: the VALUE randomised trial. Lancet. 2004 Jun 19;363(9426):2022-31. — View Citation

Kelley GA, Kelley KS. Isometric handgrip exercise and resting blood pressure: a meta-analysis of randomized controlled trials. J Hypertens. 2010 Mar;28(3):411-8. doi: 10.1097/HJH.0b013e3283357d16. Erratum in: J Hypertens. 2010 Aug;28(8):1784. — View Citation

Kerber RE, Miller RA, Najjar SM. Myocardial ischemic effects of isometric, dynamic and combined exercise in coronary artery disease. Chest. 1975 Apr;67(4):388-94. — View Citation

Kiveloff B, Huber O. Brief maximal isometric exercise in hypertension. J Am Geriatr Soc. 1971 Dec;19(12):1006-12. — View Citation

Lewis SF, Taylor WF, Bastian BC, Graham RM, Pettinger WA, Blomqvist CG. Haemodynamic responses to static and dynamic handgrip before and after autonomic blockade. Clin Sci (Lond). 1983 Jun;64(6):593-9. — View Citation

McGowan CL, Levy AS, Millar PJ, Guzman JC, Morillo CA, McCartney N, Macdonald MJ. Acute vascular responses to isometric handgrip exercise and effects of training in persons medicated for hypertension. Am J Physiol Heart Circ Physiol. 2006 Oct;291(4):H1797-802. Epub 2006 Apr 28. — View Citation

McGowan CL, Visocchi A, Faulkner M, Verduyn R, Rakobowchuk M, Levy AS, McCartney N, MacDonald MJ. Isometric handgrip training improves local flow-mediated dilation in medicated hypertensives. Eur J Appl Physiol. 2007 Feb;99(3):227-34. Epub 2006 Nov 15. Erratum in: Eur J Appl Physiol. 2008 May;103(2):251. — View Citation

Millar PJ, Bray SR, MacDonald MJ, McCartney N. The hypotensive effects of isometric handgrip training using an inexpensive spring handgrip training device. J Cardiopulm Rehabil Prev. 2008 May-Jun;28(3):203-7. doi: 10.1097/01.HCR.0000320073.66223.a7. — View Citation

Millar PJ, Bray SR, McGowan CL, MacDonald MJ, McCartney N. Effects of isometric handgrip training among people medicated for hypertension: a multilevel analysis. Blood Press Monit. 2007 Oct;12(5):307-14. — View Citation

Millar PJ, MacDonald MJ, Bray SR, McCartney N. Isometric handgrip exercise improves acute neurocardiac regulation. Eur J Appl Physiol. 2009 Nov;107(5):509-15. doi: 10.1007/s00421-009-1142-2. Epub 2009 Aug 13. — View Citation

Millar PJ, MacDonald MJ, McCartney N. Effects of isometric handgrip protocol on blood pressure and neurocardiac modulation. Int J Sports Med. 2011 Mar;32(3):174-80. doi: 10.1055/s-0030-1268473. Epub 2010 Dec 16. — View Citation

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Millar, PJ. Isometric handgrip training: a natural hypertensive therapy. TownsendLetter: The Examiner of Alternative Medicine 2008.

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Owen A, Wiles J, Swaine I. Effect of isometric exercise on resting blood pressure: a meta analysis. J Hum Hypertens. 2010 Dec;24(12):796-800. doi: 10.1038/jhh.2010.13. Epub 2010 Feb 25. — View Citation

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* Note: There are 48 references in allClick here to view all references

Outcome

Type Measure Description Time frame Safety issue
Primary Change from Baseline in Systolic Blood Pressure to Day 70 ± 2 Days Comparative assessment in the change from Baseline in seated cuff Systolic Blood Pressure after ten(10) weeks of treatment between patients treated with the Zona Plus nominal device ("stronger grip") and patients treated with the Placebo control device ("weaker grip"). A reduction in Systolic Blood = 5 Preassure after 10 weeks of treatment is considered to be a better outcome. Change from Baseline to Day 70 ±2 Days
Secondary Change from Baseline in Diastolic Blood Pressure to Day 70 ± 2 Days Comparative assessment of the change from Baseline in seated cuff Diastolic Blood Pressure after 10 weeks of treatment between patients treated with the Zona Plus nominal device ("stronger grip") and patients treated with the Placebo control device ("weaker grip"). Change from Baseline to Day 70 ±2 Days
Secondary Percentage change from Baseline in Systolic Blood Pressure reduction at Day 70 ± 2 Days Comparative assessment in the percentage of patients who achieve a clinically significant Systolic Blood Pressure reduction (defined as = 5 mmHg) at Day 70 ± 2 Days. Change from Baseline to Day 70 ± 2 Days
Secondary Percentage change from Baseline in Diastolic Blood Pressure reduction at Day 70 ± 2 Days Comparative assessment in the percentage of patients who achieve a clinically significant Diastolic Blood Pressure reduction (defined as =3 mmHg) at Day 70 ± 2 Days. Change from Baseline to Day 70 ± 2 Days
Secondary Percentage change from Baseline in Systolic Blood Pressure reduction at Day 160 ± 4 Days Comparative assessment in change from Baseline in the seated cuff Systolic Blood Pressure after 6 months Day 160 ± 4 of treatment between patients treated with the Zona Plus nominal device and patients treated with the Placebo control device. Change from Baseline to Day 160 ± 4 Days
Secondary Percentage change in Diastolic Blood Pressure reduction at Day 160 ± 4 Days Comparative assessment in change from Baseline in the seated cuff Diastolic Blood Pressure after 6 months Day 160 ± 4 Days of treatment between patients treated with the Zona Plus nominal device and patients treated with the Placebo control device. Change from Baseline to Day 160 ± 4 Days
Secondary Percentage change from Baseline in Systolic Blood Pressure reduction at Day 160 ± 4 Days Comparative assessment in the percentage of patients who achieve a clinically significant Systolic Blood Pressure reduction (defined as = 5 mmHg) at Day 160 ± 4 Days Change from Baseline to Day 160 ± 4 Days
Secondary Percentage change in Diastolic Blood Pressure reduction at Day 160 ± 4 Days Comparative assessment in the percentage of patients who achieve a clinically significant Diastolic Blood Pressure reduction defined as =3 mmHg at Day 160 ± 4 Days Change from Baseline to Day 160 ± 4 Days
Secondary Comparison of Heart Rate between Zona Plus nominal device and Placebo controlled device The Heart Rate (HR) will be recorded and compared between the Zona Plus nominal device and the Placebo control device treatment groups. Change from Baseline to Day 160 ± 4 Days
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