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HypertensionNCT03046420

Hypertension in Long-Term Care Facilities

An observational study of Hypertension, run by Louisiana State University Health Sciences Center in New Orleans at 1 site in United States.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

This study is exploratory in nature and seeks to describe hypertension diagnosis and management among patients in long-term care (LTC) facilities. Specifically, the primary objective is to: Identify LTC patients who are diagnosed with hypertension and assess the management and different outcomes of proper control of… Read more about this study

Who is it for?
Ages 65 years and older
Conditions the study is for
Hypertension
What is being tested?
Chart review
How many people
139 participants
Where
1 siteUnited States
Study dates
26 Jan 2017to 25 Jun 2018
Phase
Observational
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 65 years and older
  • All sexes
  • No healthy volunteers
  • Older adult

Study population: The study population will consist of patients residing at a LTC facility affiliated with Louisiana State University Health Sciences Center in New Orleans (LSUHSC-NO) at the start of data collection for a minimum of three months period. Chart and claims data will be collected retrospectively back to one year from date of the start date of data abstraction.

Who may be able to join

  • Being diagnosed with hypertension
  • Be ≥ 60 years of age
  • Stays at the LTC facility for at least 3 months

Who cannot join

  • Patients under age of 60 Patients without diagnosis of hypertension Terminally ill patients and hospice patients

Trial locations and contacts

1 site in 1 country.

United States1 site
  • LSU Health Sciences Center

    New Orleans, Louisiana, 70112

Other trials in United States

About this study

Official title: Hypertension Prevalence, Treatment Patterns and Outcomes in Long-Term Care Facilities

This study is exploratory in nature and seeks to describe hypertension diagnosis and management among patients in long-term care (LTC) facilities.

Specifically, the primary objective is to:

Read more
  • Identify LTC patients who are diagnosed with hypertension and assess the management and different outcomes of proper control of BP regarding to incidence of falls, cognitive decline, kidney diseases, cardiovascular diseases and incidence of cerebrovascular accidents

The secondary objectives are to:

Describe treatment patterns of hypertension in LTC facilities

  • Identify patients who are receiving non-pharmacological treatment and effectiveness of this modality of treatment.
  • Identify different classes of drugs used to treat hypertension in patients staying at LTC facility
  • Identify different drug adverse effects encountered by patients receiving medical treatment.
  • Identify patients who achieved normal blood pressure according to current guidelines
Read the detailed description

Isolated systolic hypertension is more common in elderly than younger adults. Also blood pressure (BP) in elderly tends to be very high, difficult to treat. Many studies are done to understand the mechanism of hypertension in older adults, most of them concluded that the main mechanisms are chronic inflammation, oxidative stress and endothelial dysfunction. Hypertension is often called a "silent killer" and it is a major high risk factor of heart, chronic kidney and cerebrovascular diseases . Systolic BP (SBP) gradually increases from early adulthood to old age, whilst diastolic BP (DBP) increases until around 50 years of age then reaches a plateau before decreasing again , causing widening of pulse pressure, and elevated blood pressure known as Isolated Systolic Hypertension (ISH).

There is a general consensus across international guidelines for a recommended target BP of SBP ≤ 140 mmHg and DBP≤90 mmHg for the general adult population without diabetes mellitus (DM) however the treatment of hypertension in the elderly requires further clarification and further studies as many international guidelines are inconsistent in providing recommendation on optimal BP for both initiation ant of therapy ad for treatment in the elderly due to the limited outcome date form randomized controlled trials (RCT) in this population .

The American Heart Association recommendations to initiate treatment starting with lifestyle changes and then medication if necessary at 140/90 mmHg until age 80, then at 150/90 mmHg for adults ˃ 80 years old '

The 2014 Joint National Committee's eights report (JNC 8) recommends that in general population aged ≥60 years, to initiate pharmacologic treatment to lower BP at systolic BP (SBP) ≥150 mm Hg or diastolic BP (DBP) ≥90 mm Hg and treat to a goal SBP<150 mm Hg and goal DBP <90 mm Hg . However Reisin et al published a commentary on JNC 8 disagreeing with it, having a concern that increasing the SBP level requiring treatment in those ≥60 years old to ≥150/≥90 mmHg may adversely affect renal function.

As Per the European society of Cardiology and the European Society of Hypertension: in elderly patients drug treatment is recommended when systolic BP is ≥160 mmHg, or ≥140 mmHg if younger than 80 years and treatment is well tolerated. It is not recommended to initiate antihypertensive treatment at high normal BP and in younger patients with isolated systolic hypertension.

As per 2011 NICE guidelines the aim for target average blood pressure is <135/85 mmHg for People <80 years old and <145/85mmHg for people ≥80 years .

Conditions
Hypertension
Being tested
Chart review
Medical subject headings
Hypertension

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Chart reviewOther

    This is a retrospective chart review study. The charts of patients who meet the inclusion criteria will be abstracted into a standardized electronic case report form, as described in Section 5. A standardized case report form for each patient will be created so as to collect uniform data. Charts data for one year back to the start date of data abstraction will be included in the study

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Management of Hypertension

    outcomes of proper control of blood pressure regarding to incidence of falls, cognitive decline, kidney diseases, cardiovascular diseases and incidence of cerebrovascular accidents

    Measured: 1 year

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted8 Feb 2017 (estimated)
  2. Study start26 Jan 2017
  3. Primary completion31 Aug 2017
  4. Study completion25 Jun 2018

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Observational
Observational model
Other
Time perspective
Retrospective
Enrolment
139 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT03046420
Sponsor's protocol ID
LSUIRB 9571
Status last verified
May 2021
First submitted
6 Feb 2017
Last updated
20 May 2021
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Publications

  • Ostchega Y, Dillon CF, Hughes JP, Carroll M, Yoon S. Trends in hypertension prevalence, awareness, treatment, and control in older U.S. adults: data from the National Health and Nutrition Examination Survey 1988 to 2004. J Am Geriatr Soc. 2007 Jul;55(7):1056-65. doi: 10.1111/j.1532-5415.2007.01215.x.

    PubMed 17608879
  • Butt DA, Harvey PJ. Benefits and risks of antihypertensive medications in the elderly. J Intern Med. 2015 Dec;278(6):599-626. doi: 10.1111/joim.12446. Epub 2015 Oct 26.

    PubMed 26497967
  • Franklin SS, Jacobs MJ, Wong ND, L'Italien GJ, Lapuerta P. Predominance of isolated systolic hypertension among middle-aged and elderly US hypertensives: analysis based on National Health and Nutrition Examination Survey (NHANES) III. Hypertension. 2001 Mar;37(3):869-74. doi: 10.1161/01.hyp.37.3.869.

    PubMed 11244010
  • Buford TW. Hypertension and aging. Ageing Res Rev. 2016 Mar;26:96-111. doi: 10.1016/j.arr.2016.01.007. Epub 2016 Feb 1.

    PubMed 26835847
  • Franklin SS. Hypertension in older people: part 1. J Clin Hypertens (Greenwich). 2006 Jun;8(6):444-9. doi: 10.1111/j.1524-6175.2006.05113.x.

    PubMed 16760685
  • Franklin SS, Gustin W 4th, Wong ND, Larson MG, Weber MA, Kannel WB, Levy D. Hemodynamic patterns of age-related changes in blood pressure. The Framingham Heart Study. Circulation. 1997 Jul 1;96(1):308-15. doi: 10.1161/01.cir.96.1.308.

    PubMed 9236450
  • Kjeldsen S, Feldman RD, Lisheng L, Mourad JJ, Chiang CE, Zhang W, Wu Z, Li W, Williams B. Updated national and international hypertension guidelines: a review of current recommendations. Drugs. 2014 Nov;74(17):2033-51. doi: 10.1007/s40265-014-0306-5.

    PubMed 25315030
  • Go AS, Bauman MA, Coleman King SM, Fonarow GC, Lawrence W, Williams KA, Sanchez E. An effective approach to high blood pressure control: a science advisory from the American Heart Association, the American College of Cardiology, and the Centers for Disease Control and Prevention. J Am Coll Cardiol. 2014 Apr 1;63(12):1230-1238. doi: 10.1016/j.jacc.2013.11.007. Epub 2013 Nov 15. No abstract available.

    PubMed 24246165
  • James PA, Oparil S, Carter BL, Cushman WC, Dennison-Himmelfarb C, Handler J, Lackland DT, LeFevre ML, MacKenzie TD, Ogedegbe O, Smith SC Jr, Svetkey LP, Taler SJ, Townsend RR, Wright JT Jr, Narva AS, Ortiz E. 2014 evidence-based guideline for the management of high blood pressure in adults: report from the panel members appointed to the Eighth Joint National Committee (JNC 8). JAMA. 2014 Feb 5;311(5):507-20. doi: 10.1001/jama.2013.284427.

    PubMed 24352797
  • Reisin E, Harris RC, Rahman M. Commentary on the 2014 BP guidelines from the panel appointed to the Eighth Joint National Committee (JNC 8). J Am Soc Nephrol. 2014 Nov;25(11):2419-24. doi: 10.1681/ASN.2014040371. Epub 2014 Aug 11.

    PubMed 25114277
  • Mancia G, Fagard R, Narkiewicz K, Redon J, Zanchetti A, Bohm M, Christiaens T, Cifkova R, De Backer G, Dominiczak A, Galderisi M, Grobbee DE, Jaarsma T, Kirchhof P, Kjeldsen SE, Laurent S, Manolis AJ, Nilsson PM, Ruilope LM, Schmieder RE, Sirnes PA, Sleight P, Viigimaa M, Waeber B, Zannad F, Redon J, Dominiczak A, Narkiewicz K, Nilsson PM, Burnier M, Viigimaa M, Ambrosioni E, Caufield M, Coca A, Olsen MH, Schmieder RE, Tsioufis C, van de Borne P, Zamorano JL, Achenbach S, Baumgartner H, Bax JJ, Bueno H, Dean V, Deaton C, Erol C, Fagard R, Ferrari R, Hasdai D, Hoes AW, Kirchhof P, Knuuti J, Kolh P, Lancellotti P, Linhart A, Nihoyannopoulos P, Piepoli MF, Ponikowski P, Sirnes PA, Tamargo JL, Tendera M, Torbicki A, Wijns W, Windecker S, Clement DL, Coca A, Gillebert TC, Tendera M, Rosei EA, Ambrosioni E, Anker SD, Bauersachs J, Hitij JB, Caulfield M, De Buyzere M, De Geest S, Derumeaux GA, Erdine S, Farsang C, Funck-Brentano C, Gerc V, Germano G, Gielen S, Haller H, Hoes AW, Jordan J, Kahan T, Komajda M, Lovic D, Mahrholdt H, Olsen MH, Ostergren J, Parati G, Perk J, Polonia J, Popescu BA, Reiner Z, Ryden L, Sirenko Y, Stanton A, Struijker-Boudier H, Tsioufis C, van de Borne P, Vlachopoulos C, Volpe M, Wood DA. 2013 ESH/ESC guidelines for the management of arterial hypertension: the Task Force for the Management of Arterial Hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). Eur Heart J. 2013 Jul;34(28):2159-219. doi: 10.1093/eurheartj/eht151. Epub 2013 Jun 14. No abstract available.

    PubMed 23771844
  • Jaques H; National Institute for Health and Clinical Excellence (NICE). NICE guideline on hypertension. Eur Heart J. 2013 Feb;34(6):406-8. No abstract available.

    PubMed 23520636
  • Weber MA, Schiffrin EL, White WB, Mann S, Lindholm LH, Kenerson JG, Flack JM, Carter BL, Materson BJ, Ram CV, Cohen DL, Cadet JC, Jean-Charles RR, Taler S, Kountz D, Townsend R, Chalmers J, Ramirez AJ, Bakris GL, Wang J, Schutte AE, Bisognano JD, Touyz RM, Sica D, Harrap SB. Clinical practice guidelines for the management of hypertension in the community a statement by the American Society of Hypertension and the International Society of Hypertension. J Hypertens. 2014 Jan;32(1):3-15. doi: 10.1097/HJH.0000000000000065. No abstract available.

    PubMed 24270181
  • Stevens PE, Levin A; Kidney Disease: Improving Global Outcomes Chronic Kidney Disease Guideline Development Work Group Members. Evaluation and management of chronic kidney disease: synopsis of the kidney disease: improving global outcomes 2012 clinical practice guideline. Ann Intern Med. 2013 Jun 4;158(11):825-30. doi: 10.7326/0003-4819-158-11-201306040-00007.

    PubMed 23732715
  • Dasgupta K, Quinn RR, Zarnke KB, Rabi DM, Ravani P, Daskalopoulou SS, Rabkin SW, Trudeau L, Feldman RD, Cloutier L, Prebtani A, Herman RJ, Bacon SL, Gilbert RE, Ruzicka M, McKay DW, Campbell TS, Grover S, Honos G, Schiffrin EL, Bolli P, Wilson TW, Lindsay P, Hill MD, Coutts SB, Gubitz G, Gelfer M, Vallee M, Prasad GV, Lebel M, McLean D, Arnold JM, Moe GW, Howlett JG, Boulanger JM, Larochelle P, Leiter LA, Jones C, Ogilvie RI, Woo V, Kaczorowski J, Burns KD, Petrella RJ, Hiremath S, Milot A, Stone JA, Drouin D, Lavoie KL, Lamarre-Cliche M, Tremblay G, Hamet P, Fodor G, Carruthers SG, Pylypchuk GB, Burgess E, Lewanczuk R, Dresser GK, Penner SB, Hegele RA, McFarlane PA, Khara M, Pipe A, Oh P, Selby P, Sharma M, Reid DJ, Tobe SW, Padwal RS, Poirier L; Canadian Hypertension Education Program. The 2014 Canadian Hypertension Education Program recommendations for blood pressure measurement, diagnosis, assessment of risk, prevention, and treatment of hypertension. Can J Cardiol. 2014 May;30(5):485-501. doi: 10.1016/j.cjca.2014.02.002. Epub 2014 Feb 22.

    PubMed 24786438

Questions about this trial

What is this clinical trial studying?

An observational study of Hypertension, run by Louisiana State University Health Sciences Center in New Orleans at 1 site in United States.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 3 inclusion and 1 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 20 May 2021. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in United States. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Management of Hypertension (time frame: 1 year). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT03046420, which also lists 20 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 20 May 2021.

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