This prospective, open-label, non-randomized study evaluates the effectiveness and safety of a CART BP pro(a brand name of cuffless ambulatory blood pressure monitoring device)-guided blood pressure management strategy in Korean patients with uncontrolled hypertension. Participants are allocated to either a CART BP pro-guided management group or a usual care group based on clinical decision and participant preference. The primary efficacy endpoint is 24-hour mean ambulatory systolic blood pressure at 24 weeks; safety outcomes including treatment-emergent adverse events (TEAEs) are also assessed.

Hypertension remains suboptimally controlled despite combination pharmacotherapy, and office blood pressure measurements may not adequately reflect true ambulatory blood pressure burden and nocturnal patterns. CART BP pro is a wearable, cuffless photoplethysmography-based continuous blood pressure monitoring device. This study investigates whether a CART BP pro-guided antihypertensive titration strategy improves 24-hour ambulatory blood pressure control compared with usual care in real-world outpatient settings. Participants receive standard antihypertensive medications (e.g., angiotensin receptor blocker [ARB], calcium channel blocker [CCB], thiazide diuretic) per guideline-based care. In the CART BP pro-guided group, medication adjustments are informed by CART BP pro-derived 24-hour blood pressure data. Follow-up is 24 weeks with optional extended follow-up to 48 weeks.

Inclusion Criteria:

1. Age >= 19 years
2. Office systolic blood pressure(BP) >= 140 mmHg or diastolic BP >= 90 mmHg
3. Able and willing to provide written informed consent and comply with follow-up visits

Exclusion Criteria:

1. History of intolerance to olmesartan, amlodipine, or hydrochlorothiazide
2. Suspected secondary hypertension
3. Atrial fibrillation
4. Pregnancy or lactation
5. Other serious medical condition that may interfere with study participation

De-identified individual participant data collected in this study are not currently planned to be shared with external researchers. Data sharing may be considered in the future subject to institutional review board approval and institutional data governance policies.