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Young Adult Hypertension Self-Management Clinical Trial (MyHEART)

Primary Purpose

Hypertension, Blood Pressure, Lifestyle Risk Reduction

Status
Completed
Phase
Not Applicable
Locations
United States
Study Type
Interventional
Intervention
Home Blood Pressure Monitoring
Telephone Health Coaching
Sponsored by
University of Wisconsin, Madison
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Hypertension focused on measuring Hypertension, Young Adult, Self-Management, Health coach

Eligibility Criteria

18 Years - 39 Years (Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • Willing and capable of giving written informed consent
  • Willing to comply with all study procedures and be available for the duration of the study
  • Males and females ages 18-39 years old at the start of the study (inclusive)
  • A minimum of two hypertension ICD-10 coded visits with a provider (physician [MD, DO], physician assistant, nurse practitioner) on different dates in the last 24 months, with at least one code in the past 18 months
  • Medically homed at an IRB approved healthcare system

Exclusion Criteria:

  • History of medically determined Congestive Heart Failure
  • Unable to provide informed consent (i.e., activated healthcare power of attorney)
  • Unable or unwilling to travel to local clinic for research visits
  • Currently residing in a skilled nursing facility
  • Diagnosed with sickle cell anemia or cystic fibrosis
  • Diagnosed with stroke, myocardial infarction, and/or coronary artery revascularization in the past 2 years
  • Syncope while exercising or doing strenuous activity within past 12 months
  • Currently prescribed warfarin, novel oral anticoagulant, or insulin
  • Planned organ transplant or prior transplant in the past 5 years
  • Chemotherapy or radiation therapy within 6 the past months
  • Severely impaired hearing, vision, or speech, as determined by study staff responsible for enrollment
  • Current participation or planning to participate in another clinical trial in the next 12 months
  • Pregnant or planning to become pregnant in the next 12 months
  • Planning to leave the geographic area in the next 6 months
  • Health condition that will limit both increasing physical activity and changing diet
  • Illegal drug use (other than marijuana) in the past 30 days
  • Unable to read or communicate in English
  • Currently on dialysis or seeing a Nephrologist
  • Unaware or denies history of high blood pressure or hypertension
  • Between-arm blood pressure difference >20 mmHg
  • White Coat Hypertension (24-hour ambulatory monitoring)
  • Inability to comply with or complete the protocol or other reasons at the discretion of the principal and site investigators
  • Prisoners

Sites / Locations

  • University of Wisconsin School of Medicine & Public Health
  • Aurora Health Care

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

No Intervention

Arm Label

Intervention

Usual clinical care

Arm Description

Telephone health coaching, home blood pressure monitoring, individualized goal setting, and tailored educational materials

Usual care arm participants will receive routine hypertension clinical care per their primary care provider.

Outcomes

Primary Outcome Measures

24-hour Systolic Ambulatory Blood Pressure (mmHg)
24-hour Systolic Ambulatory Blood Pressure measured at baseline, 6 months, and 12 months.
24-hour Diastolic Ambulatory Blood Pressure (mmHg)
24-hour Diastolic Ambulatory Blood Pressure measured at baseline, 6 months, and 12 months.
Clinic Systolic Blood Pressure (mmHg)
Systolic Blood Pressure measured at baseline, 6 months, and 12 months.
Clinic Diastolic Blood Pressure (mmHg)
Clinic Diastolic Blood Pressure measured at baseline, 6 months, and 12 months.

Secondary Outcome Measures

Number of Participants That Achieve Hypertension Control at 6 Months
Hypertension Control: Percentage of participants that achieve hypertension control at 6 months. Hypertension control will be defined using ambulatory blood pressures as the gold standard (<130/80 mmHg); otherwise a clinic blood pressure of <140/90 mmHg will be used.
Sodium Intake as Assessed by the Automated Self-Administered 24-hour Dietary Assessment
Mean daily sodium intake (milligrams/day) at baseline, 6 months, and 12 months as assessed by the computer administered Automated Self-Administered 24-hour Dietary Assessment
Number of Combined Fruit and Vegetable Servings as Assessed by the Automated Self-Administered 24-hour Dietary Assessment
Mean number of combined fruit and vegetable servings measured at baseline, 6 months, and 12 months as assessed by the computer administered Automated Self-Administered 24-hour Dietary Assessment, reported in cups equivalent.
Ounces of Whole Grain as Assessed by the Automated Self-Administered 24-hour Dietary Assessment
Ounces of whole grain measured at baseline, 6 months, and 12 months as assessed by the computer administered Automated Self-Administered 24-hour Dietary Assessment
Saturated Fat as Assessed by the Automated Self-Administered 24-hour Dietary Assessment
Saturated fat measured at baseline, 6 months, and 12 months as assessed by the computer administered Automated Self-Administered 24-hour Dietary Assessment, reported in percent kilocalories
Physical Activity as Assessed by the Godin Physical Activity Questionnaire
Mean weekly amounts of physical activity as assessed by the Godin Physical Activity Questionnaire. The Godin Physical Activity Questionnaire measures a person's strenuous, moderate, and light physical activity in a week. Scoring is calculated as follows (units are times per week that the participant engaged in any of the 3 classifications of activity longer than 15 minutes during their free time): 9 x strenous units reported + 5 x moderate units reported + 3 x light units reported = score A minimum score of 0 indicates no activity, a score of less than 14 is interpreted as insufficiently active or sedentary, a score between 14 and 23 is interpreted to be moderately active, and a score of 24 and higher is interpreted to be active, a theoretical maximum does not exist.
Home Blood Pressure Monitoring Frequency
Self-report of home blood pressure monitoring frequency measured at baseline, 6 months, and 12 months.
Standing Weight (kg)
Weight (kg) measured at baseline, 6 months, and 12 months.
Perceived Competence as Assessed by the Perceived Competence Scale for Diet
Perceived competence measured at baseline, 6 months, and 12 months as assessed by the Perceived Competence Scale (self-administration). This is a 4-item survey scored on a 7 point likert scale from 1 (not at all true) to 7 (very true). Mean score from 1-7 will be reported with higher scores indicating increased perceived competence.
Perceived Competence as Assessed by the Perceived Competence Scale for Exercise
Perceived competence measured at baseline, 6 months, and 12 months as assessed by the Perceived Competence Scale (self-administration). This is a 4-item survey scored on a 7 point likert scale from 1 (not at all true) to 7 (very true). Mean score from 1-7 will be reported with higher scores indicating increased perceived competence.
Perceived Autonomy as Assessed by the Health Care Climate Questionnaire for Diet
Perceived autonomy measured at baseline, 6 months, and 12 months as assessed by the Health Care Climate Questionnaire (self-administration). This is a 6-item survey scored on a 7 point likert scale from 1 (not at all true) to 7 (very true). Mean between 1-7 will be reported with higher scores indicative of increased perceived autonomy.
Perceived Autonomy as Assessed by the Health Care Climate Questionnaire for Exercise
Perceived autonomy measured at baseline, 6 months, and 12 months as assessed by the Health Care Climate Questionnaire (self-administration). This is a 6-item survey scored on a 7 point likert scale from 1 (not at all true) to 7 (very true). Mean between 1-7 will be reported with higher scores indicative of increased perceived autonomy.
Autonomous Motivation as Assessed by the Treatment Self-Regulation Questionnaire for Diet
Autonomous motivation measured at baseline, 6 months, and 12 months as assessed by the Treatment Self-Regulation Questionnaire (self-administration). This is a 15-item survey scored on a 7 point likert scale from 1 (not at all true) to 7 (very true). Mean score between 1 and 7 will be reported with higher scores indicative of increased autonomous motivation.
Autonomous Motivation as Assessed by the Treatment Self-Regulation Questionnaire for Exercise
Autonomous motivation measured at baseline, 6 months, and 12 months as assessed by the Treatment Self-Regulation Questionnaire (self-administration). This is a 15-item survey scored on a 7 point likert scale from 1 (not at all true) to 7 (very true). Mean score between 1 and 7 will be reported with higher scores indicative of increased autonomous motivation.
Controlled Motivation as Assessed by the Treatment Self-Regulation Questionnaire for Diet
Controlled motivation measured at baseline, 6 months, and 12 months as assessed by the Treatment Self-Regulation Questionnaire (self-administration). This is a 15-item survey scored on a 7 point likert scale from 1 (not at all true) to 7 (very true). Mean score between 1 and 7 will be reported with higher scores indicative of increased controlled motivation.
Controlled Motivation as Assessed by the Treatment Self-Regulation Questionnaire for Exercise
Controlled motivation measured at baseline, 6 months, and 12 months as assessed by the Treatment Self-Regulation Questionnaire (self-administration). This is a 15-item survey scored on a 7 point likert scale from 1 (not at all true) to 7 (very true). Mean score between 1 and 7 will be reported with higher scores indicative of increased controlled motivation.
Amotivation as Assessed by the Treatment Self-Regulation Questionnaire for Diet
Amotivation measured at baseline, 6 months, and 12 months as assessed by the Treatment Self-Regulation Questionnaire (self-administration). This is a 15-item survey scored on a 7 point likert scale from 1 (not at all true) to 7 (very true). Mean score between 1 and 7 will be reported with higher scores indicative of increased amotivation.
Amotivation as Assessed by the Treatment Self-Regulation Questionnaire for Exercise
Amotivation measured at baseline, 6 months, and 12 months as assessed by the Treatment Self-Regulation Questionnaire (self-administration). This is a 15-item survey scored on a 7 point likert scale from 1 (not at all true) to 7 (very true). Mean score between 1 and 7 will be reported with higher scores indicative of increased amotivation.

Full Information

First Posted
May 15, 2017
Last Updated
May 15, 2023
Sponsor
University of Wisconsin, Madison
Collaborators
National Heart, Lung, and Blood Institute (NHLBI), Aurora Health Care
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1. Study Identification

Unique Protocol Identification Number
NCT03158051
Brief Title
Young Adult Hypertension Self-Management Clinical Trial
Acronym
MyHEART
Official Title
The MyHEART Study: A Young Adult Hypertension Self-Management Randomized Controlled Trial
Study Type
Interventional

2. Study Status

Record Verification Date
May 2023
Overall Recruitment Status
Completed
Study Start Date
October 2, 2017 (Actual)
Primary Completion Date
January 13, 2022 (Actual)
Study Completion Date
February 8, 2022 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
University of Wisconsin, Madison
Collaborators
National Heart, Lung, and Blood Institute (NHLBI), Aurora Health Care

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
Yes

5. Study Description

Brief Summary
This is a 5-year randomized controlled trial in two large healthcare systems (Madison and Milwaukee, WI) to evaluate MyHEART's (My Hypertension Education And Reaching Target) impact on blood pressure among 310 geographically and racially/ethnically diverse young adults.
Detailed Description
Aim 1. To evaluate the effect of MyHEART (home blood pressure monitor distribution and heath coaching) on clinical outcomes, the change in systolic and diastolic blood pressure (primary) and hypertension control (secondary) after 6 and 12 months, compared to usual clinical care. Aim 2. To evaluate the effect of MyHEART on hypertension self-management behavior (behavioral outcomes) at 6 and 12 months, compared to usual clinical care. Aim 3. To examine whether MyHEART's effects on self-management behavior are mediated through variables of perceived competence, autonomy, motivation, and activation (mediation outcomes).

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Hypertension, Blood Pressure, Lifestyle Risk Reduction
Keywords
Hypertension, Young Adult, Self-Management, Health coach

7. Study Design

Primary Purpose
Treatment
Study Phase
Not Applicable
Interventional Study Model
Parallel Assignment
Masking
InvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
316 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Intervention
Arm Type
Experimental
Arm Description
Telephone health coaching, home blood pressure monitoring, individualized goal setting, and tailored educational materials
Arm Title
Usual clinical care
Arm Type
No Intervention
Arm Description
Usual care arm participants will receive routine hypertension clinical care per their primary care provider.
Intervention Type
Behavioral
Intervention Name(s)
Home Blood Pressure Monitoring
Intervention Description
Intervention arm participants will receive a home blood pressure monitor, home blood pressure log, and training on accurate home monitoring. They will be asked to share their home blood pressure readings during health coach telephone calls.
Intervention Type
Behavioral
Intervention Name(s)
Telephone Health Coaching
Intervention Description
Intervention arm participants will receive a health coach phone call every 2 weeks for 6 months, for a total of 12 calls. During each call, the health coach will review and discuss home blood pressures and address barriers and concerns to hypertension management. During each telephone call, the coach will guide the participant on selecting health behavior goals. Intervention arm participants will also receive handouts about hypertension management during the study visits and after health coach calls.
Primary Outcome Measure Information:
Title
24-hour Systolic Ambulatory Blood Pressure (mmHg)
Description
24-hour Systolic Ambulatory Blood Pressure measured at baseline, 6 months, and 12 months.
Time Frame
baseline, 6 month, and 12 month follow-up
Title
24-hour Diastolic Ambulatory Blood Pressure (mmHg)
Description
24-hour Diastolic Ambulatory Blood Pressure measured at baseline, 6 months, and 12 months.
Time Frame
baseline, 6 month, and 12 month follow-up
Title
Clinic Systolic Blood Pressure (mmHg)
Description
Systolic Blood Pressure measured at baseline, 6 months, and 12 months.
Time Frame
baseline, 6 month, and 12 month follow-up
Title
Clinic Diastolic Blood Pressure (mmHg)
Description
Clinic Diastolic Blood Pressure measured at baseline, 6 months, and 12 months.
Time Frame
baseline, 6 month, and 12 month follow-up
Secondary Outcome Measure Information:
Title
Number of Participants That Achieve Hypertension Control at 6 Months
Description
Hypertension Control: Percentage of participants that achieve hypertension control at 6 months. Hypertension control will be defined using ambulatory blood pressures as the gold standard (<130/80 mmHg); otherwise a clinic blood pressure of <140/90 mmHg will be used.
Time Frame
up to 6 months
Title
Sodium Intake as Assessed by the Automated Self-Administered 24-hour Dietary Assessment
Description
Mean daily sodium intake (milligrams/day) at baseline, 6 months, and 12 months as assessed by the computer administered Automated Self-Administered 24-hour Dietary Assessment
Time Frame
baseline, 6 month, and 12 month follow-up
Title
Number of Combined Fruit and Vegetable Servings as Assessed by the Automated Self-Administered 24-hour Dietary Assessment
Description
Mean number of combined fruit and vegetable servings measured at baseline, 6 months, and 12 months as assessed by the computer administered Automated Self-Administered 24-hour Dietary Assessment, reported in cups equivalent.
Time Frame
baseline, 6 month, and 12 month follow-up
Title
Ounces of Whole Grain as Assessed by the Automated Self-Administered 24-hour Dietary Assessment
Description
Ounces of whole grain measured at baseline, 6 months, and 12 months as assessed by the computer administered Automated Self-Administered 24-hour Dietary Assessment
Time Frame
baseline, 6 month, and 12 month follow-up
Title
Saturated Fat as Assessed by the Automated Self-Administered 24-hour Dietary Assessment
Description
Saturated fat measured at baseline, 6 months, and 12 months as assessed by the computer administered Automated Self-Administered 24-hour Dietary Assessment, reported in percent kilocalories
Time Frame
baseline, 6 month, and 12 month follow-up
Title
Physical Activity as Assessed by the Godin Physical Activity Questionnaire
Description
Mean weekly amounts of physical activity as assessed by the Godin Physical Activity Questionnaire. The Godin Physical Activity Questionnaire measures a person's strenuous, moderate, and light physical activity in a week. Scoring is calculated as follows (units are times per week that the participant engaged in any of the 3 classifications of activity longer than 15 minutes during their free time): 9 x strenous units reported + 5 x moderate units reported + 3 x light units reported = score A minimum score of 0 indicates no activity, a score of less than 14 is interpreted as insufficiently active or sedentary, a score between 14 and 23 is interpreted to be moderately active, and a score of 24 and higher is interpreted to be active, a theoretical maximum does not exist.
Time Frame
baseline, 6 month, and 12 month follow-up
Title
Home Blood Pressure Monitoring Frequency
Description
Self-report of home blood pressure monitoring frequency measured at baseline, 6 months, and 12 months.
Time Frame
baseline, 6 month, and 12 month follow-up
Title
Standing Weight (kg)
Description
Weight (kg) measured at baseline, 6 months, and 12 months.
Time Frame
baseline, 6 month, and 12 month follow-up
Title
Perceived Competence as Assessed by the Perceived Competence Scale for Diet
Description
Perceived competence measured at baseline, 6 months, and 12 months as assessed by the Perceived Competence Scale (self-administration). This is a 4-item survey scored on a 7 point likert scale from 1 (not at all true) to 7 (very true). Mean score from 1-7 will be reported with higher scores indicating increased perceived competence.
Time Frame
baseline, 6 month, and 12 month follow-up
Title
Perceived Competence as Assessed by the Perceived Competence Scale for Exercise
Description
Perceived competence measured at baseline, 6 months, and 12 months as assessed by the Perceived Competence Scale (self-administration). This is a 4-item survey scored on a 7 point likert scale from 1 (not at all true) to 7 (very true). Mean score from 1-7 will be reported with higher scores indicating increased perceived competence.
Time Frame
baseline, 6 month, and 12 month follow-up
Title
Perceived Autonomy as Assessed by the Health Care Climate Questionnaire for Diet
Description
Perceived autonomy measured at baseline, 6 months, and 12 months as assessed by the Health Care Climate Questionnaire (self-administration). This is a 6-item survey scored on a 7 point likert scale from 1 (not at all true) to 7 (very true). Mean between 1-7 will be reported with higher scores indicative of increased perceived autonomy.
Time Frame
baseline, 6 month, and 12 month follow-up
Title
Perceived Autonomy as Assessed by the Health Care Climate Questionnaire for Exercise
Description
Perceived autonomy measured at baseline, 6 months, and 12 months as assessed by the Health Care Climate Questionnaire (self-administration). This is a 6-item survey scored on a 7 point likert scale from 1 (not at all true) to 7 (very true). Mean between 1-7 will be reported with higher scores indicative of increased perceived autonomy.
Time Frame
baseline, 6 month, and 12 month follow-up
Title
Autonomous Motivation as Assessed by the Treatment Self-Regulation Questionnaire for Diet
Description
Autonomous motivation measured at baseline, 6 months, and 12 months as assessed by the Treatment Self-Regulation Questionnaire (self-administration). This is a 15-item survey scored on a 7 point likert scale from 1 (not at all true) to 7 (very true). Mean score between 1 and 7 will be reported with higher scores indicative of increased autonomous motivation.
Time Frame
baseline, 6 month, and 12 month follow-up
Title
Autonomous Motivation as Assessed by the Treatment Self-Regulation Questionnaire for Exercise
Description
Autonomous motivation measured at baseline, 6 months, and 12 months as assessed by the Treatment Self-Regulation Questionnaire (self-administration). This is a 15-item survey scored on a 7 point likert scale from 1 (not at all true) to 7 (very true). Mean score between 1 and 7 will be reported with higher scores indicative of increased autonomous motivation.
Time Frame
baseline, 6 month, and 12 month follow-up
Title
Controlled Motivation as Assessed by the Treatment Self-Regulation Questionnaire for Diet
Description
Controlled motivation measured at baseline, 6 months, and 12 months as assessed by the Treatment Self-Regulation Questionnaire (self-administration). This is a 15-item survey scored on a 7 point likert scale from 1 (not at all true) to 7 (very true). Mean score between 1 and 7 will be reported with higher scores indicative of increased controlled motivation.
Time Frame
baseline, 6 month, and 12 month follow-up
Title
Controlled Motivation as Assessed by the Treatment Self-Regulation Questionnaire for Exercise
Description
Controlled motivation measured at baseline, 6 months, and 12 months as assessed by the Treatment Self-Regulation Questionnaire (self-administration). This is a 15-item survey scored on a 7 point likert scale from 1 (not at all true) to 7 (very true). Mean score between 1 and 7 will be reported with higher scores indicative of increased controlled motivation.
Time Frame
baseline, 6 month, and 12 month follow-up
Title
Amotivation as Assessed by the Treatment Self-Regulation Questionnaire for Diet
Description
Amotivation measured at baseline, 6 months, and 12 months as assessed by the Treatment Self-Regulation Questionnaire (self-administration). This is a 15-item survey scored on a 7 point likert scale from 1 (not at all true) to 7 (very true). Mean score between 1 and 7 will be reported with higher scores indicative of increased amotivation.
Time Frame
baseline, 6 month, and 12 month follow-up
Title
Amotivation as Assessed by the Treatment Self-Regulation Questionnaire for Exercise
Description
Amotivation measured at baseline, 6 months, and 12 months as assessed by the Treatment Self-Regulation Questionnaire (self-administration). This is a 15-item survey scored on a 7 point likert scale from 1 (not at all true) to 7 (very true). Mean score between 1 and 7 will be reported with higher scores indicative of increased amotivation.
Time Frame
baseline, 6 month, and 12 month follow-up
Other Pre-specified Outcome Measures:
Title
Health Coach Fidelity to the Study Intervention
Description
Evaluation of health coach fidelity to administering the motivational interviewing intervention per protocol will be assessed every 2 months using a modified Behavior Change Counseling Index
Time Frame
through completion of administering the study intervention, an average of 4 years
Title
Adverse Events
Description
Number and type of adverse events
Time Frame
Through study completion, an average of 5 years
Title
Serious Adverse Events
Description
Number and type of serious adverse events
Time Frame
Through study completion, an average of 5 years
Title
Withdrawal
Description
Subject Withdrawal Rate
Time Frame
Through study completion, an average of 5 years

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
39 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Willing and capable of giving written informed consent Willing to comply with all study procedures and be available for the duration of the study Males and females ages 18-39 years old at the start of the study (inclusive) A minimum of two hypertension ICD-10 coded visits with a provider (physician [MD, DO], physician assistant, nurse practitioner) on different dates in the last 24 months, with at least one code in the past 18 months Medically homed at an IRB approved healthcare system Exclusion Criteria: History of medically determined Congestive Heart Failure Unable to provide informed consent (i.e., activated healthcare power of attorney) Unable or unwilling to travel to local clinic for research visits Currently residing in a skilled nursing facility Diagnosed with sickle cell anemia or cystic fibrosis Diagnosed with stroke, myocardial infarction, and/or coronary artery revascularization in the past 2 years Syncope while exercising or doing strenuous activity within past 12 months Currently prescribed warfarin, novel oral anticoagulant, or insulin Planned organ transplant or prior transplant in the past 5 years Chemotherapy or radiation therapy within 6 the past months Severely impaired hearing, vision, or speech, as determined by study staff responsible for enrollment Current participation or planning to participate in another clinical trial in the next 12 months Pregnant or planning to become pregnant in the next 12 months Planning to leave the geographic area in the next 6 months Health condition that will limit both increasing physical activity and changing diet Illegal drug use (other than marijuana) in the past 30 days Unable to read or communicate in English Currently on dialysis or seeing a Nephrologist Unaware or denies history of high blood pressure or hypertension Between-arm blood pressure difference >20 mmHg White Coat Hypertension (24-hour ambulatory monitoring) Inability to comply with or complete the protocol or other reasons at the discretion of the principal and site investigators Prisoners
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Kara Hoppe, DO
Organizational Affiliation
University of Wisconsin, Madison
Official's Role
Principal Investigator
Facility Information:
Facility Name
University of Wisconsin School of Medicine & Public Health
City
Madison
State/Province
Wisconsin
ZIP/Postal Code
53792
Country
United States
Facility Name
Aurora Health Care
City
Milwaukee
State/Province
Wisconsin
ZIP/Postal Code
53233
Country
United States

12. IPD Sharing Statement

Plan to Share IPD
No
Citations:
PubMed Identifier
30677485
Citation
Johnson HM, Sullivan-Vedder L, Kim K, McBride PE, Smith MA, LaMantia JN, Fink JT, Knutson Sinaise MR, Zeller LM, Lauver DR. Rationale and study design of the MyHEART study: A young adult hypertension self-management randomized controlled trial. Contemp Clin Trials. 2019 Mar;78:88-100. doi: 10.1016/j.cct.2019.01.010. Epub 2019 Jan 21.
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Young Adult Hypertension Self-Management Clinical Trial

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