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Updated: May 26, 2025
A Novel Digital Platform for a Monitored Home-based Cardiac Rehabilitation Program
Published on: April 19, 2019
A randomised trial comparing usual versus strict home blood pressure control in elderly patients with hypertension:
Dong-Yan Zhang1, Yi-Qing Zhang1, De-Wei An1
1Department of Cardiovascular Medicine, Shanghai Institute of Hypertension, Shanghai Key Laboratory of Hypertension, National Research Centre for Translational Medicine, State Key Laboratory of Medical Genomics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Insights
This study investigates optimal home blood pressure (HBP) targets for preventing cardiovascular events in elderly Chinese patients with hypertension. It aims to determine if tighter HBP control reduces complications compared to standard control.
Area of Science:
- Cardiology
- Hypertension Management
- Clinical Trials
Background:
- Optimal home blood pressure (HBP) targets for cardiovascular complication prevention remain undefined.
- Elderly individuals with hypertension often require precise blood pressure management strategies.
Purpose of the Study:
- To evaluate the efficacy of tight versus standard HBP control in reducing cardiovascular events in older hypertensive patients.
- To establish optimal HBP targets for long-term cardiovascular health in a community setting.
Main Methods:
- The Home Blood Pressure Intervention in the Community Trial (HomeBP) is a nationwide, randomized clinical trial in China.
- 10,000 hypertensive patients aged 60-80 years will be randomized to HBP targets of 125-134/75-84 mmHg or <125/75 mmHg for 4 years.
- A sophisticated IT system facilitates real-time data transfer and specialist-guided treatment adjustments.
Main Results:
- Currently, 2281 patients are randomized with no significant baseline differences between groups.
- The primary composite outcome includes cardiovascular death, myocardial infarction, stroke, and heart failure hospitalization.
- Ongoing data collection and analysis will determine the impact of different HBP targets.
Conclusions:
- The HomeBP trial is actively investigating the optimal level of home blood pressure for preventing cardiovascular complications in elderly hypertensive patients.
- Findings will inform clinical guidelines for managing hypertension in community settings.
- This research addresses a critical gap in understanding HBP control strategies.
Objective:
The optimal level of home blood pressure (HBP) for the prevention of cardiovascular complications is unknown. The Home Blood Pressure Intervention in the Community Trial (HomeBP, [NCT05858944]) is addressing this issue by randomising elderly hypertensive patients to standard or tight HBP control.
Methods And Analysis:
HomeBP is an investigator-initiated randomised clinical trial with open design and blinded endpoint evaluation. Eligible patients of either sex, aged 60-80 years, having uncontrolled home hypertension (≥135/85 mm Hg) after medication for at least 2 weeks will be recruited nationwide in China at up to 200 community healthcare centres. After stratification for centre and the presence of office hypertension (≥140/90 mm Hg), 10,000 patients will be randomised in a 1:1 proportion to a target HBP of 125-134/75-84 mm Hg or <125/75 mm Hg and followed up for 4 years. The primary outcome is a composite of cardiovascular death, non-fatal myocardial infarction, coronary revascularisation, unstable angina pectoris or heart failure requiring hospitalisation, and non-fatal stroke. Follow-up visits are scheduled monthly for 3 months after randomisation and 3-monthly thereafter. Patients record HBP for 7 consecutive days before every visit. A unique feature of the trial is the information technology setup, allowing the secure and instantaneous flow of HBP and other data to the study coordinating centre, where a standardised HBP report is generated. Hypertension specialists at Ruijin Hospital, Shanghai and at local tertiary hospitals provide treatment recommendations, which are transmitted to the caregivers at the community centres, who then fine-tune the treatment recommendations in a shared decision process with the patients to meet the values and clinical needs of the patients. Currently, 2281 patients have been randomised with no between-group differences in the baseline characteristics.
Abstract:
Trial registration number. URL: https://www.clinicaltrials.gov; Unique identifier: NCT05858944.
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