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Blood PressureNCT03130257

Blood Pressure Checks for Diagnosing Hypertension (BP-CHECK)

A study testing Clinic Blood Pressure Measurement, Home Blood Pressure Measurement and Kiosk Blood Pressure Measurement in people with Blood Pressure, run by Kaiser Permanente 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

Hypertension is usually diagnosed at a clinic or doctor's office when a patient has blood pressure (BP) that is high for several measurements. However, about 30 percent of patients with high BP in clinics have normal BP outside of clinics. This is called white-coat hypertension. Read more about this study

Who is it for?
Ages 18 to 85 yearsHealthy volunteers can take part
Conditions the study is for
Blood Pressure
What is being tested?
Clinic Blood Pressure Measurement, Home Blood Pressure Measurement and Kiosk Blood Pressure Measurement
Could I receive a placebo?
No, everyone receives an active treatment
How many people
510 participants
Where
1 siteUnited States
Study dates
11 May 2017to 26 Aug 2019
Phase
Interventional
Are there results?
Yes, posted in the registrySummary in the doctors' view

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 18 to 85 years
  • All sexes
  • Healthy volunteers accepted
  • Adult, Older adult

Who may be able to join

  • enrolled in the health plan for two years, no diagnosis of hypertension in the prior 2 years or more,
  • not on anti-hypertensive medications,
  • a high blood pressure at their last clinic visit (systolic blood pressure > or equal to 140 mm Hg or diastolic blood pressure > or equal to 90,
  • planning to remain a Kaiser Permanente patient for the next six months,
  • able to converse and read in English,
  • required to have elevated blood pressure at the screening visit (BP taken 2 times, high each time).

Who cannot join

  • children and pregnant women,
  • patients with end-stage renal disease,
  • dementia,
  • atrial fibrillation and other significant arrhythmias.

Trial locations and contacts

1 site in 1 country.

United States1 site
  • Kaiser Permanente Washington

    Seattle, Washington, 98023

Other trials in United States

About this study

Hypertension is usually diagnosed at a clinic or doctor's office when a patient has blood pressure (BP) that is high for several measurements. However, about 30 percent of patients with high BP in clinics have normal BP outside of clinics. This is called white-coat hypertension. Correct diagnosis of hyper-tension is important to prevent strokes, heart attacks, and heart failure but also to avoid making people worry or take medicines when they don't need to.

To avoid misdiagnosis of hypertension, the US Preventive Services Task Force (USPSTF), which makes national recommendations about disease screening, recommends people should have 24-hour BP ambulatory monitoring (i.e., an arm cuff and BP monitor worn for 24 hours, with measurements taken every 30 minutes during the day and every 60 minutes at night), with home BP monitoring over several days as an alternative. However, most patients have never heard of 24-hour BP monitoring, and physicians rarely order it. Physicians sometimes use home BP monitoring, but not according to recommended guidelines. BP kiosks, for example at drug stores, offer another option. Newer models are accurate and easy to use.

Read more

BP-CHECK will identify participants, ages 18 to 85, with high BP at their last clinic visit and invite them to a screening visit. Participants with high BP at the screening visit (510 patients) will be randomized and assigned to 1) clinic BP, 2) home BP, or 3) kiosk BP diagnostic groups for confirming a new diagnosis of hypertension. The clinic BP group will have BP measured at one clinic visit. The home BP group will measure BP two times, twice a day, for five days. The kiosk BP group will measure BP three times on three separate days at a kiosk at their clinic or nearby drugstore. Participants will complete their diagnostic tests over approximately three weeks. They will then be asked to complete 24-hour BP monitoring. Participants will complete surveys at baseline prior to randomization, after diagnostic tests, and at six months.

Hypothesis 1: Compared to the reference standard (24-hour BP), home BP and kiosk BP will be more accurate than clinic BP. Hypothesis 2: Participants with clinic, home, or kiosk BP results concordant with reference standard results will prefer home or kiosk to clinic and 24-hour BP. Hypothesis 2: Participants with clinic, home, or kiosk BP results concordant with reference standard results will prefer home or kiosk to clinic and 24-hour BP.

Read the detailed description

The investigators will compare the accuracy and acceptability (i.e., comfort, convenience) of clinic, home, and kiosk BP testing to 24-hour BP ambulatory monitoring. The investigators will look at the impact of the study on outcomes that matter to participants: their BP and whether participants feel better or worse overall, worry about BP, and change health behaviors (e.g., lowering salt intake).

Our study team includes patients. The study team also has patient and stakeholder advisors to ensure our study is conducted properly and is not a burden to patients and providers. The investigators will share study results with patient participants and publish papers in scientific journals.

Conditions
Blood Pressure
Being tested
Clinic Blood Pressure Measurement, Home Blood Pressure Measurement, Kiosk Blood Pressure Measurement, 24-hour Ambulatory Blood Pressure Monitoring (Reference Standard)
Keywords
blood pressure measurement

What participants receive

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

  • Clinic Blood Pressure MeasurementDiagnostic test

    Participants will be asked to check their blood pressure once within the subsequent three weeks.

  • Home Blood Pressure MeasurementDiagnostic test

    Participants will receive a validated upper-arm home blood pressure monitor and asked to two measurements in the morning and two in the evening for at least 5 days over three weeks.

  • Kiosk Blood Pressure MeasurementDiagnostic test

    Participants will be asked to use a validated blood pressure kiosk in their clinic or local pharmacy to measure their blood pressure three times on three separate days over three weeks.

  • 24-hour Ambulatory Blood Pressure Monitoring (Reference Standard)Diagnostic test

    Participants will be asked to wear an arm cuff and ambulatory blood pressure monitor for 24 hours, with measurements taken every 30 minutes during the day and every 60 minutes at night.

Study groups in NCT03130257
Study groupRoleWhat they receive
Clinic Blood Pressure MeasurementActive comparatorParticipants will be asked to check their blood pressure at their clinic once within the subsequent three weeks.
Receives: Diagnostic Test: Clinic Blood Pressure Measurement; Diagnostic Test: 24-hour Ambulatory Blood Pressure Monitoring (Reference Standard)
Home Blood Pressure MeasurementActive comparatorParticipants will receive a validated upper-arm home blood pressure monitor and asked to take two measurements in the morning and two in the evening for at least 5 days over three weeks.
Receives: Diagnostic Test: Home Blood Pressure Measurement; Diagnostic Test: 24-hour Ambulatory Blood Pressure Monitoring (Reference Standard)
Kiosk Blood Pressure MeasurementActive comparatorParticipants will be asked to use a validated blood pressure kiosk in their clinic or local pharmacy to measure their blood pressure three times on three separate days over three weeks.
Receives: Diagnostic Test: Kiosk Blood Pressure Measurement; Diagnostic Test: 24-hour Ambulatory Blood Pressure Monitoring (Reference Standard)

What is being measured

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

  1. Comparative Performance of Clinic, Home, and Kiosk

    To compare the performance of clinic, home, and kiosk blood pressure to 24-hour blood pressure (reference standard) for new hypertension diagnoses. Our primary outcome is differences in mean systolic and diastolic blood pressure comparing clinic, home, and kiosk to 24-hour BP.

    Measured: Randomization to three weeks

Timeline

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

  1. First posted26 Apr 2017
  2. Study start11 May 2017
  3. Primary completion26 Aug 2019
  4. Study completion26 Aug 2019

Resources

More details

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

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Screening
Allocation
Randomised
Intervention model
Parallel groups
Masking
None (open label)
Enrolment
510 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT03130257
Sponsor's protocol ID
CER-1511-32979
Status last verified
Oct 2020
First submitted
21 Apr 2017
Last updated
16 Nov 2020
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Yes: A final de-identified data set will be made available to the Patient-Centered Outcome Research Institute (PCORI). This data set will include de-identified, individual-level data and meet specifications set by our Institutional Review Board for sharing such data. The analytic data set will include data dictionaries and descriptions of the data such as cohort identification, study participant characteristics, and data captured electronically and via patient surveys. Parties may request data from Dr. Beverly Green and will need to indicate their plans for data use, acknowledge the source of the data in publications, and, if possible, collaborate with BP-CHECK research group.

Publications

  • Hansell LD, Hsu CW, Munson SA, Margolis KL, Thompson MJ, Ehrlich KJ, Hall YN, Anderson ML, Evers SC, Marcus-Smith MS, McClure JB, Green BB. Patient Experiences With Blood Pressure Measurement Methods for Hypertension Diagnosis: Qualitative Findings From the BP-CHECK Study. Am J Hypertens. 2024 Oct 14;37(11):868-875. doi: 10.1093/ajh/hpae088.

    PubMed 38995194
  • Hall YN, Anderson ML, McClure JB, Ehrlich K, Hansell LD, Hsu CW, Margolis KL, Munson SA, Thompson MJ, Green BB. Relationship of Blood Pressure, Health Behaviors, and New Diagnosis and Control of Hypertension in the BP-CHECK Study. Circ Cardiovasc Qual Outcomes. 2024 Feb;17(2):e010119. doi: 10.1161/CIRCOUTCOMES.123.010119. Epub 2024 Feb 8.

    PubMed 38328915
  • Green BB, Anderson ML, McClure JB, Ehrlich K, Hall YN, Hansell L, Hsu C, Margolis KL, Munson SA, Thompson MJ. Is Hypertension Diagnostic Testing and Diagnosis Associated With Psychological Distress? Am J Hypertens. 2024 Jan 1;37(1):69-76. doi: 10.1093/ajh/hpad083.

    PubMed 37688515
  • Hsu C, Hansell L, Ehrlich K, Munson S, Anderson M, Margolis KL, McClure JB, Hall YN, Thompson M, Joseph D, Green BB. Primary care physician beliefs and practices regarding blood pressure measurement: results from BP-CHECK qualitative interviews. BMC Prim Care. 2023 Jan 25;24(1):30. doi: 10.1186/s12875-022-01950-1.

    PubMed 36698062
  • Thompson MJ, Anderson ML, Cook AJ, Ehrlich K, Hall YN, Hsu C, Margolis KL, McClure JB, Munson SA, Green BB. Acceptability and Adherence to Home, Kiosk, and Clinic Blood Pressure Measurement Compared to 24-H Ambulatory Monitoring. J Gen Intern Med. 2023 Jun;38(8):1854-1861. doi: 10.1007/s11606-023-08036-3. Epub 2023 Jan 17.

    PubMed 36650328
  • Green BB, Anderson ML, Cook AJ, Ehrlich K, Hall YN, Hsu C, Joseph D, Klasnja P, Margolis KL, McClure JB, Munson SA, Thompson MJ. Clinic, Home, and Kiosk Blood Pressure Measurements for Diagnosing Hypertension: a Randomized Diagnostic Study. J Gen Intern Med. 2022 Sep;37(12):2948-2956. doi: 10.1007/s11606-022-07400-z. Epub 2022 Mar 3.

    PubMed 35239109
  • Green BB, Anderson ML, Campbell J, Cook AJ, Ehrlich K, Evers S, Hall YN, Hsu C, Joseph D, Klasnja P, Margolis KL, McClure JB, Munson SA, Thompson MJ. Blood pressure checks and diagnosing hypertension (BP-CHECK): Design and methods of a randomized controlled diagnostic study comparing clinic, home, kiosk, and 24-hour ambulatory BP monitoring. Contemp Clin Trials. 2019 Apr;79:1-13. doi: 10.1016/j.cct.2019.01.003. Epub 2019 Jan 8.

    PubMed 30634036

Questions about this trial

What is this clinical trial studying?

A study testing Clinic Blood Pressure Measurement, Home Blood Pressure Measurement and Kiosk Blood Pressure Measurement in people with Blood Pressure, run by Kaiser Permanente 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 6 inclusion and 4 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 16 Nov 2020. 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?

Yes. Results are posted in the registry (first posted 16 Nov 2020). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.

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?

Comparative Performance of Clinic, Home, and Kiosk (time frame: Randomization to three weeks). 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 NCT03130257, which also lists 7 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 16 Nov 2020.

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