Home Blood Pressure Study for Recent Stroke Survivors With High Blood Pressure *On Hold Due to Global Pandemic*

NCT ID: NCT04226157

Last Updated: 2020-04-09

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

UNKNOWN

Clinical Phase

NA

Total Enrollment

32 participants

Study Classification

INTERVENTIONAL

Study Start Date

2019-02-21

Study Completion Date

2021-03-31

Brief Summary

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The purpose of this pilot study is to assess the feasibility of implementing a home blood pressure self-management program in a population of recent stroke survivors in the Washington, D.C. area. The investigators hypothesize that hypertensive stroke survivors in the Washington, DC area who participate in the Home Blood Pressure Monitoring program will have a greater reduction in mean systolic blood pressure (SBP) from baseline to 3 months, as measured by automated office blood pressure (AOBP), as compared to usual care.

Detailed Description

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The purpose of this trial is to determine if a home blood pressure self-management (HBPS) program, including home monitoring and medication adjustments, is practical to use in recent stroke survivors and whether or not it is associated with lowering blood pressure after 3 months. Data from this trial may be used to do more research and may be used by doctors when seeing patients.This research is being done because high blood pressure, also called hypertension, is the leading risk factor for stroke. Lowering blood pressure (BP) has been shown to lower the risk of future strokes. The majority of stroke survivors continue to have uncontrolled BP. Currently, blood pressure (BP) is most often measured in the doctor's office. However, those single BP measurements are not the best picture of blood pressure over time and can be influenced by the stress of being in a doctor's office, known as the "white coat effect". This is why measuring BP at home may paint a more accurate picture of a patient's true long-term BP. Home blood pressure monitoring (HBPM) is recommended in the recently updated national hypertension guidelines. Home BP monitoring plus guided BP medication self-adjustments is associated with lower BP in patients with high blood pressure. The investigators believe that a HBPS program, including medication self-adjustment and home monitoring, may help to reduce blood pressure in patients with hypertension within 3 months.

Conditions

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Ischemic Stroke Hypertension

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Patients with hypertension who have had a stroke within the past 6 months will be randomized into two groups in a one to one ratio: Home Blood Pressure Self-Management (HBPS) or Usual Care.
Primary Study Purpose

PREVENTION

Blinding Strategy

NONE

Study Groups

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Home Blood Pressure Self Management

The HBPS group will check their blood pressure at home daily using a smart BP cuff with telemonitoring capability (Home Qardio) and guided to use a self-titration plan between office visits for persistently elevate blood pressures.

Group Type EXPERIMENTAL

Home Blood Pressure Monitoring Device (Qardio Arm)

Intervention Type DEVICE

The Home Blood Pressure Device with telemonitoring capability will allow the participants and physician to monitor blood pressure over time and titrate blood pressure medications as needed for persistently elevated blood pressure.

Usual Care

The Usual Care group will have their blood pressure monitored and medications adjusted by their primary care provider.

Group Type ACTIVE_COMPARATOR

Primary Care Provider Blood Pressure Management

Intervention Type OTHER

Participant will follow up as would normally do with primary care provider for blood pressure management.

Interventions

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Home Blood Pressure Monitoring Device (Qardio Arm)

The Home Blood Pressure Device with telemonitoring capability will allow the participants and physician to monitor blood pressure over time and titrate blood pressure medications as needed for persistently elevated blood pressure.

Intervention Type DEVICE

Primary Care Provider Blood Pressure Management

Participant will follow up as would normally do with primary care provider for blood pressure management.

Intervention Type OTHER

Other Intervention Names

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Medication Self-Titration

Eligibility Criteria

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Inclusion Criteria

* Acute ischemic stroke in the past 180 days of screening
* Age \>/= 18 years old
* Automated Office Blood Pressure ≥135 systolic or ≥85 diastolic at time of screening
* Stage 2 hypertension (as defined by \>140 mmHg SBP and or \>90 mmHg DBP on 2 occasions or history of hypertension prior to stroke or currently taking antihypertensive medications)
* Able to live independently (as defined by modified Rankin scale score of 0-2)

Exclusion Criteria

* CKD stage IV or greater (GFR \< 30)
* Inability to check BP in either arm (e.g. amputation, lymphedema)
* Pregnancy
* High-grade intracranial or extracranial stenosis requiring a higher BP goal
* Unable to provide informed consent for themselves in English or Spanish
* Life expectancy less than 12 months
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Medstar Health Research Institute

OTHER

Sponsor Role collaborator

MedStar Georgetown University Hospital

OTHER

Sponsor Role lead

Responsible Party

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Dr. Mary Carter Denny

Assistant Professor of Neurology

Responsibility Role PRINCIPAL_INVESTIGATOR

Locations

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Medstar Georgetown University Hospital

Washington D.C., District of Columbia, United States

Site Status RECRUITING

Countries

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United States

Central Contacts

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Mary Carter Denny, MD

Role: CONTACT

202-444-8532

Facility Contacts

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Mary Carter Denny

Role: primary

202-444-8532

References

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Reference Type BACKGROUND
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Reference Type BACKGROUND
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Reference Type BACKGROUND
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Reference Type BACKGROUND
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Margolis KL, Asche SE, Bergdall AR, Dehmer SP, Groen SE, Kadrmas HM, Kerby TJ, Klotzle KJ, Maciosek MV, Michels RD, O'Connor PJ, Pritchard RA, Sekenski JL, Sperl-Hillen JM, Trower NK. Effect of home blood pressure telemonitoring and pharmacist management on blood pressure control: a cluster randomized clinical trial. JAMA. 2013 Jul 3;310(1):46-56. doi: 10.1001/jama.2013.6549.

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Reference Type BACKGROUND
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Other Identifiers

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2018-0718

Identifier Type: -

Identifier Source: org_study_id

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