FCCC LOGO Faculty Publications
Huang X , Liu L , Song Y , Gao L , Zhao M , Bao H , Qin X , Wu Y , Wu Q , Bi C , Yue A , Fang C , Ma H , Cui Y , Tang G , Li P , Zhang Y , Li J , Wang B , Xu X , Wang H , Parati G , Spence JD , Wang X , Huo Y , Chen G , Cheng X
Achieving blood pressure control targets in hypertensive patients of rural China - a pilot randomized trial
Trials. 2020 Jun 11;21(1) :515
PMID: 32527283    PMCID: PMC7291427    URL: https://www.ncbi.nlm.nih.gov/pubmed/32527283
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Abstract
BACKGROUND: This study aimed to test the feasibility and titration methods used to achieve specific blood pressure (BP) control targets in hypertensive patients of rural China. METHODS: A randomized, controlled, open-label trial was conducted in Rongcheng, China. We enrolled 105 hypertensive participants aged over 60 years, and who had no history of stroke or cardiovascular disease. The patients were randomly assigned to one of three systolic-BP target groups: standard: 140 to < 150 mmHg; moderately intensive: 130 to < 140 mmHg; and intensive: < 130 mmHg. The patients were followed for 6 months. DISCUSSION: The optimal target for systolic blood pressure (SBP) lowering is still uncertain worldwide and such information is critically needed, especially in China. However, in China the rates of awareness, treatment and control are only 46.9%, 40.7%, and 15.3%, respectively. It is challenging to achieve BP control in the real world and it is very important to develop population-specific BP-control protocols that fully consider the population's characteristics, such as age, sex, socio-economic status, compliance with medication, education level, and lifestyle. This randomized trial showed the feasibility and safety of the titration protocol to achieve desirable SBP targets (< 150, < 140, and < 130 mmHg) in a sample of rural, Chinese hypertensive patients. The three BP target groups had similar baseline characteristics. After 6 months of treatment, the mean SBP measured at an office visit was 137.2 mmHg, 131.1 mmHg, and 124.2 mmHg, respectively, in the three groups. Home BP and central aortic BP measurements were also obtained. At 6 months, home BP measurements (2 h after drug administration) showed a mean SBP of 130.9 mmHg in the standard group, 124.9 mmHg in the moderately intensive group, and 119.7 mmHg in the intensive group. No serious adverse events were recorded over the 6-month study period. Rates of adverse events, including dry cough, palpitations, and arthralgia, were low and showed no significant differences between the three groups. This trial provided real-world experience and laid the foundation for a future, large-scale, BP target study. TRIAL REGISTRATION: Feasibility Study of the Intensive Systolic Blood Pressure Control; ClinicalTrials.gov, ID: NCT02817503. Registered retrospectively on 29 June 2016.
Notes
1745-6215 Huang, Xiao Liu, Lishun Song, Yun Gao, Lan Zhao, Min Bao, Huihui Qin, Xianhui Wu, Yanqing Wu, Qinghua Bi, Chonglei Yue, Aiping Fang, Chongqian Ma, Hai Cui, Yimin Tang, Genfu Li, Ping Zhang, Yan Li, Jianping Wang, Binyan Xu, Xiping Wang, Hong Parati, Gianfranco Spence, J David Wang, Xiaobin Huo, Yong Chen, Guangliang Cheng, Xiaoshu investigators of intensive BP control in China 2016YFC0903103/National Key Research and Development Program 2016YFE0205400, 2018ZX09739, 2018ZX09301034003/National Key Research and Development Program 2016YFC0904900/National Key Research and Development 81500233/National Natural Science Foundation of China 20171BAB205008/Major Projects of the Science and Technology Department, Jiangxi 20161ACG70012/Major Projects of the Science and Technology Department, Jiangxi Journal Article England Trials. 2020 Jun 11;21(1):515. doi: 10.1186/s13063-020-04368-1.