Active clinical trials for "Hypertension"

The goal of this hybrid type III study incorporating a cluster-randomized trial is to assess the effect of a community health worker-led hypertension prevention and control program (CHPC) on the implementation outcomes and clinical outcomes among patient with hypertension in central Nepal. The main questions it aims to answer are: 1. What is the level of implementation outcomes, including reach, adoption, implementation fidelity, and maintenance of the CHPC implementation strategy at the patient, provider, and health system levels? 2: What is the effectiveness of the CHPC implementation strategy compared to facility-based intervention on systolic BP via a cluster randomized controlled trial. 3: What is the implementation cost and cost-effectiveness of the CHPC implementation strategy? Participants will receive counseling and blood pressure monitoring services at their home every four months for a year by a community health worker. Researchers will compare if there is a significant difference in systolic blood pressure between those who receive this intervention and those who do not receive the intervention in the same community.

This study aims to know the effectiveness of "MaRiTensi" in improving knowledge, motivation, efficacy, self-care and blood pressure control for hypertension patients. This study hypothesizes that MaRiTensi effectively increases the knowledge, motivation, self-efficacy and self-care of hypertensive patients and reduces blood pressure in the intervention group compared to the control group. Respondent recruitment is as follows: The respondent candidate will be identified based on data on record medical Appropriate respondent candidates' criteria inclusion and exclusion contacted for given informed consent Prospective respondents who are willing to participate and fulfill the criteria for pressure blood moment measurement will request signed consent Respondents fill in the basic data and recapitulate by the assistant researcher Done randomization for allocation of group interventions and group control Respondents given envelope closed (using sequentially numbered, opaque sealed envelopes (SNOSE) method ) Respondents' group intervention was given maintenance by Hospital or health center standard-added intervention using MaRiTensi by conditions; meanwhile, group control was provided care by Hospital or health center standards.

Hypertension, diabetes, and obesity are considered major risk factors for cardiovascular diseases and premature mortality worldwide. Furthermore, they have severe consequences on quality of life among patients. With increasing challenges facing the healthcare systems, pharmacists are well positioned to take on a greater role in the management of chronic diseases. The present study aims to investigate the impact of pharmacist counselling on the clinical outcomes (weight, mortality, blood pressure, blood glucose) of hypertensive, diabetic, and obese patients.

Epilepsy is a disabling and lethal neurological disease which affect 3.47 million Americans. Significant health care disparities exist in people with epilepsy (PWE). Hypertension and hyperlipidemia are highly prevalent and often go undertreated, and cardiovascular (CV) mortality is higher in people with epilepsy (PWE) than the general population. Preliminary data from our group shows that PWE have higher ACC-ASCVD risk scores than an age matched NHANES cohort without epilepsy. Preliminary data also demonstrate mortality rates in PWE due to hypertension, stroke, and diabetes are rising in the US, counter to the US general population. This proposal seeks to test the feasibility, acceptability, and preliminary efficacy of a new care model for the underserved PWE in a public health setting. In this new model, neurologists guided by standardized treatment algorithms (ACC-ASCVD estimator+) propose and initiate pharmacological interventions for hypertension and hyperlipidemia.

REPRESS is an open label, pragmatic, multicenter, randomized controlled phase III trial with blinded endpoint with 1:1 (intervention to control arm) allocation ratio. The REPRESS trial is aimed to determine the efficacy of an educational intervention aimed at reducing dietary salt intake in elderly people (60+) with moderate hypertension and exposed to polypharmacy (3+ drugs) in improving systolic BP control compared to an attention arm.

Although hypertension is an important cause of premature death, it can increase the risk of heart, brain, kidney and other diseases. Worldwide, 1 in 4 men and 1 in 5 women (over a billion people) have this condition (https://www.who.int/health-topics/hypertension#tab=tab_1 4 July 2022). The prevalence of hypertension in Turkey was determined as 32.3% in women, 28.4% in men and 30.3% in general, according to the Turkish Hypertension Prevalence (PatenT2) study (Sengul et al. 2016). Although the exact cause of hypertension is not clear, age, family history, eating habits, smoking-alcohol intake, weight and physical activity level have a strong influence on blood pressure. Hypertension management is normally easy through regular use of antihypertensive drugs and adherence to lifestyle interventions (https://world-heart-federation.org/what-we-do/hypertension/ 4 July 2022). As a matter of fact, it is stated in the World Health Organization (WHO) hypertension guideline that healthy lifestyle behaviors should be considered together with antihypertensive drugs (WHO 2021). The recommended healthy lifestyle behaviors for the prevention and control of hypertension are reducing salt consumption, high potassium intake, healthy diet, fighting obesity, regular physical activity and reducing cigarette-alcohol consumption (Mills et al. 2020). Despite the availability and high prevalence of treatment for hypertension, less than 1 in 5 people worldwide have it under control (https://www.who.int/news-room/fact-sheets/detail/hypertension 4 July 2022). In Turkey, an estimated 49.1% of adults with hypertension are unaware that they have this condition. However, less than half (46.2%) of adults with hypertension are treated and approximately 1 in 5 adults (23.9%) have it under control(https://www.who.int/publications/m/item/hypertension-tur-country-profile-turkey-2020 4 July 2022) . Although the nutritional, behavioral, and environmental causes of hypertension are well established, little is known about what actions and interventions are responsible for the low rates of awareness, treatment, and control (Zhou et al. 2021). Therefore, the development of new approaches to improve the prevention, management and control of hypertension has come to the fore(Özpulat 2017; Karmakar et al. 2018). The Turkish Hypertension Consensus report recommended that "tele-medicine" applications should be started to be used for blood pressure control and drug compliance with the advancing technology (https://fka.gov.tr/kalkinma-planlari-detayi-1564726568912 17 August 2022). Hypertension management guideline published by the Japanese Hypertension Society (JSH)-2019 explains that digital hypertension management can be facilitated using health information technology (Kario 2019). According to the International Council of Nurses (ICN), team-based care (especially virtual care) empowered through technology can respond to the change sought in healthcare delivery (ICN 2021). Likewise, WHO stated that using mobile health technologies creates important opportunities to reduce premature deaths from non-communicable diseases (WHO 2018). Mobile health technology mainly focuses on the use of mass media such as mobile phone-based or connected interventions (Gandapur et al. 2016; Karmakar et al. 2018). The near ubiquity, mobility, and direct and instantaneous nature of mobile phones and other mobile devices have enormous potential to impact healthcare delivery and health outcomes (White et al. 2016; Morawski et al. 2017; Gong et al. 2020). In the meta-analysis, it was seen that mobile health applications have a beneficial effect in health interventions to create behavior change (Iribarren et al. 2021). Another meta-analysis showed that messages given in behavior change interventions, including reducing salt intake in food, increasing physical activity, quitting smoking, increasing consumption of low-fat diet and fruit and vegetables, resulted in a significant reduction in blood pressure, in particular (Saif-Ur-Rahman et al. 2019). In our study, the Protection Motivation Theory (KMT) will be used together with the use of mobile phones in creating behavior change. KMT is a common framework describing the use of protective behaviors and can be applied to interventions designed to change behavior (Rogers 1983). In this context, this study aims to evaluate the effects of nursing interventions including mobile phone use and patient education based on CMT on drug compliance and healthy lifestyle behaviors in hypertensive patients.

Cerebrovascular diseases (CVD) and neurodegenerative diseases (NDD) are both leading causes of death in the United States. Epidemiological data have shown that increased prevalence of hypertension is related to these outcomes. However, despite the strong association of poor brain health outcomes in patients with hypertension (HTN), the understanding of cerebral blood flow (CBF) regulation and treatment options for HTN remain limited. Acupuncture treatment (AT), which is considered a promising complementary and integrative modality, has been known to reduce blood pressure and improve endothelial function in HTN. However, very few studies have investigated AT's effect on cerebrovascular function and the possible neuroprotective properties directly via regulating HTN. Exercise is used as a stimulus that increases the brain's metabolism and requires cerebrovascular responses (vasodilation) to meet the new metabolism. Therefore, the specific aim of this study is to test the hypothesis that an antihypertensive acupuncture treatment can acutely improve cerebrovascular responses in hypertensive humans during moderate exercise.

The investigators will pilot test a hypertension self-management intervention for feasibility and acceptability. The investigators will enroll adults (age ≥18) with uncontrolled hypertension, identified from the electronic health record. In this feasibility trial, the research aim is to explore trial design, participant acceptability of the intervention and outcome measures, and to generate data to inform the design of a future randomized controlled trial.

Cardiovascular disease and hypertensive disorders of pregnancy (HDP) are the leading causes of maternal morbidity and mortality in the United States. Postpartum, in office care has demonstrated to be an insufficient model of hypertensive management postpartum, largely due to barriers that women face in accessing in office care, with stark racial disparities in access. The care of postpartum patients with HDP following delivery is made up of either a single postpartum visit at 6 weeks postpartum or a fragmented and non-standardized series of in-person appointments depending on the patients' medical complications and the clinicians' experience. Further, current society guidelines outline inpatient thresholds for initiation of antihypertensive medication but do not provide recommendations for titration thereafter. The proposed study will investigate the acceptability and effectiveness of an algorithm-based, outpatient treatment model for the management of postpartum hypertension utilizing an asynchronous text-based platform as compared to the standard of care for postpartum women with a diagnosis of Hypertensive disorder of pregnancy at Massachusetts General Hospital.

Idiopathic intracranial hypertension (IIH) has significant associated morbidity and reduced quality of life. There is a significant risk of visual loss and patients also typically suffer with chronic disabling headaches. This trial has been designed to evaluate the efficacy and safety of a new formulation of exenatide (Presendin) in the reduction of intracranial pressure (ICP) in patients with IIH.