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A Pivotal Study To Evaluate The Effectiveness of Isometric Handgrip Therapy In Prehypertensive And Hypertensive Patients

Primary Purpose

Hypertension, Systolic

Status
Terminated
Phase
Not Applicable
Locations
United States
Study Type
Interventional
Intervention
Zona Plus Device
Control Device
Sponsored by
Zona Health, Inc
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Hypertension, Systolic focused on measuring Diastolic Hypertension, HandGrip Therapy, Pre-Hypertension, Isometric Exercise, Vascular Hypertension

Eligibility Criteria

18 Years - 80 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria

  • Male or female of any ethnicity between 18 and 80 years of age
  • Diagnosed with prehypertension or hypertension and verified during the Baseline visit
  • Non-use of antihypertensive medication for ≥30 prior to screening
  • Currently not taking any antihypertensive medications or decline to take any antihypertensive medications(e.g., diuretic, angiotensin-converting enzyme inhibitor (ACEI), angiotensin II receptor blocker (ARB), ] beta-blocker (BB), renin inhibitor (RI), calcium channel blocker (CCB) or alpha-adrenergic agonist (clonidine))
  • Sufficient vision with the patient able to see the screen prompts on the device, sufficient hearing with the patient able to hear the device audio prompts, sufficient hand strength (demonstrated by a maximum voluntary contraction equaling 35 units of force in both hands measured by the device)
  • Baseline Blood Pressure measurements collected and study device training completed during the Baseline visit
  • Non-use of medications and over the counter (OTC)supplement regimen related to hypertension throughout the study duration
  • Only one patient per household can participate in the study, eliminating the potential of unblinding
  • Able to comply with study procedures and agrees to complete all required study visits and associated activities
  • Ability to give written informed consent in either English, Spanish or French •≤149 mmHg, Systolic Blood Pressure wherein patients who present with Systolic Blood Pressure readings ≥140 mmHg will receive heightened monitoring throughout the first month of the study

Exclusion Criteria

  • Pregnant or not using adequate contraception
  • Blood Pressure ≥150 mmHg (systolic) and/or >90 mmHg (diastolic)
  • History of heart failure
  • Hospitalization due to a hypertensive emergency, with impending or progressive target organ dysfunction (i.e., renal dysfunction, left ventricular hypertrophy or CNS involvement) within the past six (6) months

    •>10 mmHg difference in Systolic Blood Pressure between the right and left arms collected during screening

  • Unstable Blood Pressure, defined as >5 mmHg variance between any two (2) consecutive weekly readings (with a maximum of four (4) attempts) to determine a baseline BP measurement
  • Arm circumference greater than 45cm
  • Acute illness, infection, or inflammation
  • Unstable cardiovascular disorder, such as MI, unstable angina, significant arrhythmia, stroke, or TIA within the last six (6)months, or other serious comorbidity impacting life expectancy to < than a 1 year
  • Rest or exertional angina pectoris in the previous six (6) months
  • History of solid organ transplant
  • Secondary form of hypertension (HTN) etiology, including but not limited to primary aldosteronism, chronic steroid therapy and Cushing syndrome, pheochromocytoma, aorta coarctation or untreated thyroid or parathyroid disease
  • Concurrent participation in an investigational clinical study that has not completed the follow-up period or planned participation in another study within the next six(6) months
  • Any condition or personal circumstance that, in the judgment of the investigator, might interfere with the collection of complete, good quality data or the completion of the research study
  • Currently own or have owned another Zona Plus device and are,or have been,voluntarily performing the isometric handgrip activities.

Sites / Locations

  • Saint Louis Heart & Vascular, P.C.
  • Carolinas Research Center LLC
  • Goldsboro Medical Center
  • Sante Clinical Research
  • Sun Research Institute

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Sham Comparator

Arm Label

Zona Plus - Active - "Normal Grip"

Control Device - Sham - "Weaker Grip"

Arm Description

Using the Zona Plus Device, the patient will perform a twelve-minute isometric handgrip therapy session at approximately the same time each day . After an initial handgrip strength assessment (the session calibration), a two-minute isometric routine is performed four times, two sessions per hand, with a one-minute non-grip, or rest session between each isometric routine.

Using the Zona Sham Control Device the patient will perform a twelve-minute isometric handgrip therapy session at approximately the same time each day. After an initial handgrip strength assessment (the calibration), a two-minute isometric routine is performed four times, two sessions per hand, with a one-minute non-grip, or rest session between each isometric routine.

Outcomes

Primary Outcome Measures

Change from Baseline in Systolic Blood Pressure to Day 70 ± 2 Days
Comparative assessment in the change from Baseline in seated cuff Systolic Blood Pressure after ten(10) weeks of treatment between patients treated with the Zona Plus nominal device ("stronger grip") and patients treated with the Placebo control device ("weaker grip"). A reduction in Systolic Blood ≥ 5 Preassure after 10 weeks of treatment is considered to be a better outcome.

Secondary Outcome Measures

Change from Baseline in Diastolic Blood Pressure to Day 70 ± 2 Days
Comparative assessment of the change from Baseline in seated cuff Diastolic Blood Pressure after 10 weeks of treatment between patients treated with the Zona Plus nominal device ("stronger grip") and patients treated with the Placebo control device ("weaker grip").
Percentage change from Baseline in Systolic Blood Pressure reduction at Day 70 ± 2 Days
Comparative assessment in the percentage of patients who achieve a clinically significant Systolic Blood Pressure reduction (defined as ≥ 5 mmHg) at Day 70 ± 2 Days.
Percentage change from Baseline in Diastolic Blood Pressure reduction at Day 70 ± 2 Days
Comparative assessment in the percentage of patients who achieve a clinically significant Diastolic Blood Pressure reduction (defined as ≥3 mmHg) at Day 70 ± 2 Days.
Percentage change from Baseline in Systolic Blood Pressure reduction at Day 160 ± 4 Days
Comparative assessment in change from Baseline in the seated cuff Systolic Blood Pressure after 6 months Day 160 ± 4 of treatment between patients treated with the Zona Plus nominal device and patients treated with the Placebo control device.
Percentage change in Diastolic Blood Pressure reduction at Day 160 ± 4 Days
Comparative assessment in change from Baseline in the seated cuff Diastolic Blood Pressure after 6 months Day 160 ± 4 Days of treatment between patients treated with the Zona Plus nominal device and patients treated with the Placebo control device.
Percentage change from Baseline in Systolic Blood Pressure reduction at Day 160 ± 4 Days
Comparative assessment in the percentage of patients who achieve a clinically significant Systolic Blood Pressure reduction (defined as ≥ 5 mmHg) at Day 160 ± 4 Days
Percentage change in Diastolic Blood Pressure reduction at Day 160 ± 4 Days
Comparative assessment in the percentage of patients who achieve a clinically significant Diastolic Blood Pressure reduction defined as ≥3 mmHg at Day 160 ± 4 Days
Comparison of Heart Rate between Zona Plus nominal device and Placebo controlled device
The Heart Rate (HR) will be recorded and compared between the Zona Plus nominal device and the Placebo control device treatment groups.

Full Information

First Posted
July 8, 2020
Last Updated
September 19, 2022
Sponsor
Zona Health, Inc
Collaborators
Research & Development Concierge Company
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1. Study Identification

Unique Protocol Identification Number
NCT04467879
Brief Title
A Pivotal Study To Evaluate The Effectiveness of Isometric Handgrip Therapy In Prehypertensive And Hypertensive Patients
Official Title
A Pivotal Study To Evaluate The Effectiveness of Isometric Handgrip Therapy In Prehypertensive And Hypertensive Patients
Study Type
Interventional

2. Study Status

Record Verification Date
September 2022
Overall Recruitment Status
Terminated
Why Stopped
New Protocol and Outcome Measures in Review
Study Start Date
June 1, 2020 (Actual)
Primary Completion Date
September 13, 2022 (Actual)
Study Completion Date
September 14, 2022 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Zona Health, Inc
Collaborators
Research & Development Concierge Company

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
Yes
Device Product Not Approved or Cleared by U.S. FDA
Yes
Data Monitoring Committee
Yes

5. Study Description

Brief Summary
This is a double-blind, sham-controlled clinical trial assessing the effectiveness of personalized isometric handgrip device therapy. Approximately 230 patients who present with a Systolic Blood Pressure reading of ≤ 149mmHg and who have not taken any antihypertensive medication for more than 30 days will be enrolled.
Detailed Description
This study is designed to examine the effectiveness of individualized isometric handgrip device therapy in prehypertension or hypertension patient subjects who are not at target BP and who are naive to anti-hypertensive medication for at least 30 days before screening. The investigational plan examines changes in blood pressure (BP) in up to 230 patient subjects who are randomized to either the "active" (i.e., the Zona Plus device proposed for marketing), or to a "sham" device (which is intentionally calibrated for a "weaker grip").

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Hypertension, Systolic
Keywords
Diastolic Hypertension, HandGrip Therapy, Pre-Hypertension, Isometric Exercise, Vascular Hypertension

7. Study Design

Primary Purpose
Treatment
Study Phase
Not Applicable
Interventional Study Model
Single Group Assignment
Model Description
Prospective, double-blinded, randomized, sham-controlled study
Masking
ParticipantInvestigator
Masking Description
Double Blinded
Allocation
Randomized
Enrollment
146 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Zona Plus - Active - "Normal Grip"
Arm Type
Experimental
Arm Description
Using the Zona Plus Device, the patient will perform a twelve-minute isometric handgrip therapy session at approximately the same time each day . After an initial handgrip strength assessment (the session calibration), a two-minute isometric routine is performed four times, two sessions per hand, with a one-minute non-grip, or rest session between each isometric routine.
Arm Title
Control Device - Sham - "Weaker Grip"
Arm Type
Sham Comparator
Arm Description
Using the Zona Sham Control Device the patient will perform a twelve-minute isometric handgrip therapy session at approximately the same time each day. After an initial handgrip strength assessment (the calibration), a two-minute isometric routine is performed four times, two sessions per hand, with a one-minute non-grip, or rest session between each isometric routine.
Intervention Type
Device
Intervention Name(s)
Zona Plus Device
Other Intervention Name(s)
Zona Plus 3.0
Intervention Description
Zona Plus 3.0 Individualized Isometric Handgrip Therapy Device
Intervention Type
Device
Intervention Name(s)
Control Device
Intervention Description
Zona Plus control sham device, with a nominal weaker grip
Primary Outcome Measure Information:
Title
Change from Baseline in Systolic Blood Pressure to Day 70 ± 2 Days
Description
Comparative assessment in the change from Baseline in seated cuff Systolic Blood Pressure after ten(10) weeks of treatment between patients treated with the Zona Plus nominal device ("stronger grip") and patients treated with the Placebo control device ("weaker grip"). A reduction in Systolic Blood ≥ 5 Preassure after 10 weeks of treatment is considered to be a better outcome.
Time Frame
Change from Baseline to Day 70 ±2 Days
Secondary Outcome Measure Information:
Title
Change from Baseline in Diastolic Blood Pressure to Day 70 ± 2 Days
Description
Comparative assessment of the change from Baseline in seated cuff Diastolic Blood Pressure after 10 weeks of treatment between patients treated with the Zona Plus nominal device ("stronger grip") and patients treated with the Placebo control device ("weaker grip").
Time Frame
Change from Baseline to Day 70 ±2 Days
Title
Percentage change from Baseline in Systolic Blood Pressure reduction at Day 70 ± 2 Days
Description
Comparative assessment in the percentage of patients who achieve a clinically significant Systolic Blood Pressure reduction (defined as ≥ 5 mmHg) at Day 70 ± 2 Days.
Time Frame
Change from Baseline to Day 70 ± 2 Days
Title
Percentage change from Baseline in Diastolic Blood Pressure reduction at Day 70 ± 2 Days
Description
Comparative assessment in the percentage of patients who achieve a clinically significant Diastolic Blood Pressure reduction (defined as ≥3 mmHg) at Day 70 ± 2 Days.
Time Frame
Change from Baseline to Day 70 ± 2 Days
Title
Percentage change from Baseline in Systolic Blood Pressure reduction at Day 160 ± 4 Days
Description
Comparative assessment in change from Baseline in the seated cuff Systolic Blood Pressure after 6 months Day 160 ± 4 of treatment between patients treated with the Zona Plus nominal device and patients treated with the Placebo control device.
Time Frame
Change from Baseline to Day 160 ± 4 Days
Title
Percentage change in Diastolic Blood Pressure reduction at Day 160 ± 4 Days
Description
Comparative assessment in change from Baseline in the seated cuff Diastolic Blood Pressure after 6 months Day 160 ± 4 Days of treatment between patients treated with the Zona Plus nominal device and patients treated with the Placebo control device.
Time Frame
Change from Baseline to Day 160 ± 4 Days
Title
Percentage change from Baseline in Systolic Blood Pressure reduction at Day 160 ± 4 Days
Description
Comparative assessment in the percentage of patients who achieve a clinically significant Systolic Blood Pressure reduction (defined as ≥ 5 mmHg) at Day 160 ± 4 Days
Time Frame
Change from Baseline to Day 160 ± 4 Days
Title
Percentage change in Diastolic Blood Pressure reduction at Day 160 ± 4 Days
Description
Comparative assessment in the percentage of patients who achieve a clinically significant Diastolic Blood Pressure reduction defined as ≥3 mmHg at Day 160 ± 4 Days
Time Frame
Change from Baseline to Day 160 ± 4 Days
Title
Comparison of Heart Rate between Zona Plus nominal device and Placebo controlled device
Description
The Heart Rate (HR) will be recorded and compared between the Zona Plus nominal device and the Placebo control device treatment groups.
Time Frame
Change from Baseline to Day 160 ± 4 Days

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
80 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria Male or female of any ethnicity between 18 and 80 years of age Diagnosed with prehypertension or hypertension and verified during the Baseline visit Non-use of antihypertensive medication for ≥30 prior to screening Currently not taking any antihypertensive medications or decline to take any antihypertensive medications(e.g., diuretic, angiotensin-converting enzyme inhibitor (ACEI), angiotensin II receptor blocker (ARB), ] beta-blocker (BB), renin inhibitor (RI), calcium channel blocker (CCB) or alpha-adrenergic agonist (clonidine)) Sufficient vision with the patient able to see the screen prompts on the device, sufficient hearing with the patient able to hear the device audio prompts, sufficient hand strength (demonstrated by a maximum voluntary contraction equaling 35 units of force in both hands measured by the device) Baseline Blood Pressure measurements collected and study device training completed during the Baseline visit Non-use of medications and over the counter (OTC)supplement regimen related to hypertension throughout the study duration Only one patient per household can participate in the study, eliminating the potential of unblinding Able to comply with study procedures and agrees to complete all required study visits and associated activities Ability to give written informed consent in either English, Spanish or French •≤149 mmHg, Systolic Blood Pressure wherein patients who present with Systolic Blood Pressure readings ≥140 mmHg will receive heightened monitoring throughout the first month of the study Exclusion Criteria Pregnant or not using adequate contraception Blood Pressure ≥150 mmHg (systolic) and/or >90 mmHg (diastolic) History of heart failure Hospitalization due to a hypertensive emergency, with impending or progressive target organ dysfunction (i.e., renal dysfunction, left ventricular hypertrophy or CNS involvement) within the past six (6) months •>10 mmHg difference in Systolic Blood Pressure between the right and left arms collected during screening Unstable Blood Pressure, defined as >5 mmHg variance between any two (2) consecutive weekly readings (with a maximum of four (4) attempts) to determine a baseline BP measurement Arm circumference greater than 45cm Acute illness, infection, or inflammation Unstable cardiovascular disorder, such as MI, unstable angina, significant arrhythmia, stroke, or TIA within the last six (6)months, or other serious comorbidity impacting life expectancy to < than a 1 year Rest or exertional angina pectoris in the previous six (6) months History of solid organ transplant Secondary form of hypertension (HTN) etiology, including but not limited to primary aldosteronism, chronic steroid therapy and Cushing syndrome, pheochromocytoma, aorta coarctation or untreated thyroid or parathyroid disease Concurrent participation in an investigational clinical study that has not completed the follow-up period or planned participation in another study within the next six(6) months Any condition or personal circumstance that, in the judgment of the investigator, might interfere with the collection of complete, good quality data or the completion of the research study Currently own or have owned another Zona Plus device and are,or have been,voluntarily performing the isometric handgrip activities.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Mark Young
Organizational Affiliation
Zona Health, Inc
Official's Role
Study Chair
Facility Information:
Facility Name
Saint Louis Heart & Vascular, P.C.
City
Saint Louis
State/Province
Missouri
ZIP/Postal Code
63044
Country
United States
Facility Name
Carolinas Research Center LLC
City
Charlotte
State/Province
North Carolina
ZIP/Postal Code
28215
Country
United States
Facility Name
Goldsboro Medical Center
City
Goldsboro
State/Province
North Carolina
ZIP/Postal Code
27534
Country
United States
Facility Name
Sante Clinical Research
City
Kerrville
State/Province
Texas
ZIP/Postal Code
78028
Country
United States
Facility Name
Sun Research Institute
City
San Antonio
State/Province
Texas
ZIP/Postal Code
78215
Country
United States

12. IPD Sharing Statement

Plan to Share IPD
No
IPD Sharing Plan Description
If in the future Investigators want to access the data for secondary analysis they can submit a request from the Sponsor or R&D Data Management Contact. Individual patient data will not be shared by the sponsor directly and will be aggregated, monitored, and de-identified (APD) via 1) final approved clinical study report 2) any manuscripts or summary results report via an email request to the central contact once database lock has occurred and reports are generated.
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Links:
URL
http://www.fda.gov/regulatory-information/search-fda-guidance-documents/hypertension-indication-drug-labeling-cardiovascular-outcome-claims
Description
Drug Labeling for Cardiovascular Outcome Claims
URL
http://www.fda.gov/downloads/Drugs/GuidanceComplianceRegulatoryInformation/Guidances/ucm073147.pdf
Description
Principles for ClinicalEvaluation ofNew Antihypertensive Drugs.
URL
http://www.nhlbi.nih.gov/files/docs/guidelines/jnc7full.pdf
Description
The Seventh Report of the Joint National Committee on Prevention, Detection,Evaluation, and Treatment of High Blood Pressure

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A Pivotal Study To Evaluate The Effectiveness of Isometric Handgrip Therapy In Prehypertensive And Hypertensive Patients

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