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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:
Participants will:
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| hemodynamics-based individualized antihypertensive therapy | Experimental | The antihypertensive strategy is individualized according to the patient's hemodynamic indices: High-resistance type: Amlodipine Besylate Tablets 5mg, once daily, orally. High cardiac output type: Metoprolol Sustained-Release Tablets 47.5mg, once daily, orally. Hypervolemic type: Indapamide Tablets 2.5mg, once daily, orally. |
|
| guideline-based conventional therapy | Active Comparator | Developing a monotherapy antihypertensive treatment plan for participants based on the 2024 Chinese hypertension guidelines |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| hemodynamics-based individualized antihypertensive therapy | Drug | The antihypertensive strategy is individualized according to the patient's hemodynamic indices: High-resistance type: Amlodipine Besylate Tablets 5mg, once daily, orally. High cardiac output type: Metoprolol Sustained-Release Tablets 47.5mg, once daily, orally. Hypervolemic type: Indapamide Tablets 2.5mg, once daily, orally. Participants will take the therapy for 8 weeks. |
| Measure | Description | Time Frame |
|---|---|---|
| Difference in office systolic blood pressure reduction | Difference in office systolic blood pressure reduction between two groups. | 8 weeks after treatment |
| Measure | Description | Time Frame |
|---|---|---|
| Reduction difference in office systolic blood pressure | Reduction difference in office systolic blood pressure between two groups and among subgroups of hemodynamic phenotyping in individualized antihypertensive therapy. | 4 weeks after treatment |
| Reduction difference in office diastolic blood pressure |
| Measure | Description | Time Frame |
|---|---|---|
| Adverse events | Adverse events between two groups | Eight weeks |
| Serious adverse events | Serious adverse events between two groups | Eight weeks |
Inclusion Criteria:
Exclusion Criteria:
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Coded data (without personal identification information) used and analysed during the study will be available to researchers one year after the publication date of the manuscript from the corresponding author on reasonable request, with the approval of the steering committee and Research Center for Clinical Trials of the Third Xiangya Hospital of Central South University, on signing of a data access agreement.
One year after the publication date of the manuscript.
Coded data (without personal identification information) used and analysed during the study will be available to researchers one year after the publication date of the manuscript from the corresponding author on reasonable request, with the approval of the steering committee and Research Center for Clinical Trials of the Third Xiangya Hospital of Central South University, on signing of a data access agreement.
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| ID | Term |
|---|---|
| D006973 | Hypertension |
| ID | Term |
|---|---|
| D014652 | Vascular Diseases |
| D002318 | Cardiovascular Diseases |
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| guideline-based conventional treatment | Drug | Developing a monotherapy antihypertensive treatment plan for participants based on the 2024 Chinese hypertension guidelines. Participants will take this treatment for 8 weeks. |
|
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Reduction difference in office diastolic blood pressure between two groups and among subgroups of hemodynamic phenotyping in individualized antihypertensive therapy. |
| 4 weeks after treatment |
| Reduction difference in office mean blood pressure | Reduction difference in office mean blood pressure between two groups and among subgroups of hemodynamic phenotyping in individualized antihypertensive therapy. | 4 weeks after treatment |
| Difference in pulse rate changes | Difference in pulse rate changes between two groups and among subgroups of hemodynamic phenotyping in individualized antihypertensive therapy. | 4 weeks after treatment |
| Difference in blood pressure target rate | Difference in blood pressure target rate (both systolic and diastolic blood pressure will be measured) between two groups and among subgroups of hemodynamic phenotyping in individualized antihypertensive therapy. | 4 weeks after treatment |
| Difference of systemic vascular resistance index (SVRI) changes | Difference of systemic vascular resistance index (SVRI) changes between two groups and among subgroups of hemodynamic phenotyping in individualized antihypertensive therapy. | 4 weeks after treatment |
| Difference of cardiac index (CI) changes | Difference of cardiac index (CI) changes between two groups and among subgroups of hemodynamic phenotyping in individualized antihypertensive therapy. | 4 weeks after treatment |
| Difference of thoracic fluid content (TFC) changes | Difference of thoracic fluid content (TFC) changes between two groups and among subgroups of hemodynamic phenotyping in individualized antihypertensive therapy. | 4 weeks after treatment |
| Reduction difference in office diastolic blood pressure | Reduction difference in office diastolic blood pressure between two groups and among subgroups of hemodynamic phenotyping in individualized antihypertensive therapy. | 8 weeks after treatment |
| Reduction difference in office mean blood pressure | Reduction difference in office mean blood pressure between two groups and among subgroups of hemodynamic phenotyping in individualized antihypertensive therapy. | 8 weeks after treatment |
| Difference in pulse rate changes | Difference in pulse rate changes between two groups and among subgroups of hemodynamic phenotyping in individualized antihypertensive therapy | 8 weeks after treatment |
| Difference in blood pressure target rate | Difference in blood pressure target rate (both systolic and diastolic blood pressure will be measured) between two groups and among subgroups of hemodynamic phenotyping in individualized antihypertensive therapy | 8 weeks after treatment |
| Difference of systemic vascular resistance index (SVRI) changes | Difference of systemic vascular resistance index (SVRI) changes between two groups and among subgroups of hemodynamic phenotyping in individualized antihypertensive therapy. | 8 weeks after treatment |
| Difference of cardiac index (CI) changes | Difference of cardiac index (CI) changes between two groups and among subgroups of hemodynamic phenotyping in individualized antihypertensive therapy. | 8 weeks after treatment |
| Difference of thoracic fluid content (TFC) changes | Difference of thoracic fluid content (TFC) changes between two groups and among subgroups of hemodynamic phenotyping in individualized antihypertensive therapy. | 8 weeks after treatment |
| Adverse drug reaction | Adverse drug reaction between two groups | Eight weeks |