Hypertension
Conditions
Interventions
Normal management group:Hypertensive patients shall be provided with routine management in accordance with the National Essential Public Health Services Standards (Third Edition), and family doctors a
Reinforcement management group:The intensive management group received enhanced management based on the National Essential Public Health Services Standards (Third Edition). This group used blood press
Sponsors
Army Medical Center of PLA
Eligibility
Sex/Gender
All
Age
65 Years to 79 Years
Inclusion criteria
Inclusion criteria: 1. Age is greater than 65 years old and less than or equal to 79 years old; 2. In the absence of medication, systolic blood pressure measured in the clinic on three different days is between 140-180mmHg, or patients with hypertension who are currently undergoing antihypertensive treatment; 3. At least one high-risk cardiovascular factor is met: (1) Clinical or subclinical cardiovascular and cerebrovascular diseases exist; (Clinical cardiovascular diseases include, but are not limited to: a) Previous (greater than 6 months) myocardial infarction (MI), stroke (including ischemic stroke and hemorrhagic stroke, excluding lacunar infarction and TIA), percutaneous coronary intervention (PCI), coronary artery bypass grafting (CABG), carotid endarterectomy (CE), carotid stent implantation; b) Previous (greater than 6 months) peripheral arterial disease (PAD) with revascularization; c) Previous (greater than 6 months) acute coronary syndrome, with or without resting ECG changes, ECG changes during exercise testing, or positive cardiac imaging studies; d) Coronary artery, carotid artery, or lower limb artery with at least 50% diameter stenosis; e) Abdominal aortic aneurysm (AAA) >=5 cm, regardless of whether surgical treatment is performed. Subclinical diseases include: a) Coronary artery calcium scoring (Agatston units) >=400 within the past 2 years; b) Ankle-brachial index (ABI) =6.5%) as the diagnostic criteria for diabetes. (4) According to the results of the most recent lipid laboratory test within the past 12 months, the 10-year cardiovascular disease risk assessed by the China-PAR risk assessment model is =10%. (5) Age is >=70 years old. 4. An informed consent form has been obtained and signed.
Exclusion criteria
Exclusion criteria: 1. SBP is >=180mmHg and/or DBP is =1 gram/day, or 24-hour urinary albumin excretion >=600 milligrams/day, random urine protein/creatinine ratio >=1 gram/gram creatinine, or random urine albumin/creatinine ratio >=600 milligrams/gram creatinine, or urinary routine protein >=2+. 5. The circumference of the upper arm is too large or too small, making it impossible to accurately measure blood pressure with a sphygmomanometer (such as upper arm circumference greater than 32cm). 6. Hospitalized for unstable angina within the past 3 months. 7. Acute myocardial infarction or acute stroke that occurred within the past 6 months; 8. Any organ transplant recipient. 9. Unexplained weight loss of more than 10% within the past 6 months. 10. Dilated cardiomyopathy, hypertrophic cardiomyopathy, rheumatic heart disease, congenital heart disease, severe valvular heart disease (severe valve stenosis and/or regurgitation); 11. Complicated by severe illness with a life expectancy of less than 12 months (such as malignant tumors); 12. Severe liver or renal dysfunction (ALT and/or AST) >= three times the upper limit of normal, or end-stage renal disease on dialysis, or eGFR 2.5mg/dL [>221µmol/L]; 13. Symptomatic heart failure or reduced left ventricular ejection fraction (<40%) within the past 6 months; 14. History of atrial fibrillation; 15. Hypotensive events or symptoms such as dizziness and fatigue caused by blood pressure reduction to SBP <=130mmHg (office blood pressure) during previous antihypertensive treatment, and cannot tolerate continued blood pressure reduction treatment. 16. History of allergy to medication or its components in the study; 17. Currently participating in other clinical studies; 18. Patients with disabilities, mobility impairments, intellectual disabilities, and other factors that may prevent normal participation in the study and follow-up (if necessary, assess frailty using the FRAIL scale, and assess cognitive mental state using the MMSE scale); 19. There are situations that may affect patient compliance, or the researcher believes there are other reasons that are not suitable for clinical trials. (a) History of alcohol or drug abuse within the past 12 months. (b) Planning to move away from the follow-up site within 2 years (short term) and unable to transfer to another HAO-Target follow-up site. (c) Patients with a history of not complying with medical advice or follow-up. (d) Significant concerns from the spouse, significant other, or family member about participating in the study. (e) Clinical diagnosis of dementia, and receiving medication for dementia, or the researcher judges that the subject is cognitively unable to follow the trial process. 20. Clinically diagnosed patients with high anxiety.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| non-fatal stroke;non-fatal myocardial infarction;acute heart failure;Coronary Artery Revascularization;death attributable to cardiovascular disease;Home blood pressure monitoring;Office blood pressure measurement; | — |
Secondary
| Measure | Time frame |
|---|---|
| new-onset atrial fibrillation;new-onset diabetes mellitus;Declined renal function or progression to end-stage renal disease.;Declined cognitive function or dementia;All-cause mortality;hospitalized for TIA; | — |
Countries
China
Contacts
Public ContactZeng Chunyu
Army Medical Center of PLA
Outcome results
None listed