Antihypertensive Drug Selection Based on Hemodynamic Phenotypes

A Multicenter, Randomized, PROBE Trial on Antihypertensive Drug Selection Based on Hemodynamic Phenotypes Defined by Bioelectrical Impedance Analysis

The goal of this clinical trial is to explore the clinical efficacy and safety of individualized antihypertensive medication guided by hemodynamic phenotyping. The main questions it aims to answer are:

1. Does hemodynamics-based individualized antihypertensive therapy achieve better blood pressure control compared to guideline-based conventional therapy?
2. Does hemodynamics-based individualized therapy have comparable safety to guideline-based conventional treatment? Researchers will compare hemodynamics-based individualized antihypertensive therapy to guideline-based conventional treatment to see if the former is better than the latter.

Participants will:

1. Take hemodynamics-based individualized antihypertensive therapy or guideline-based conventional treatment every day for 8 weeks
2. Visit the clinic once every 4 weeks for checkups and tests
3. Keep a diary of their symptoms and any treatment

Inclusion Criteria:

1. Aged ≥30 and <80 years, regardless of gender;
2. Confirmed diagnosis of hypertension meeting the criteria outlined in the 2024 Chinese Hypertension Guidelines: office blood pressure ≥140/90 mmHg and home blood pressure ≥135/85 mmHg;
3. Mild to moderate hypertension, with office blood pressure ranging from 140-179/90-109 mmHg;
4. No prior use of antihypertensive medications;
5. Voluntary participation in the study with written informed consent obtained.

Exclusion Criteria:

1. Diagnosed or highly suspected secondary hypertension;
2. Classified as mixed type according to hemodynamic typing;
3. Allergy to the intended antihypertensive medications;
4. Dysphagia;
5. Pregnant or lactating women;
6. Potential pregnancy plans during the trial period;
7. Uncorrected electrolyte disturbances;
8. Severe organ dysfunction;
9. Comorbid conditions leading to inaccurate blood pressure measurement;
10. Comorbid conditions or states unsuitable for noninvasive hemodynamic measurement via bioelectrical impedance;
11. Comorbid conditions contraindicating or requiring caution with trial medications;
12. Comorbid conditions affecting the absorption, distribution, metabolism, or excretion of trial drugs;
13. Concurrent or planned use of medications contraindicated or requiring caution with trial drugs;
14. Concurrent or planned use of medications interfering with trial outcomes;
15. Clinician's assessment deems the patient unsuitable for the trial's antihypertensive regimen;
16. Current participation in other clinical studies that may interfere with the conduct of this trial.