Testing a hospital program for high blood pressure in inpatients

AI summary

From the trial's eligibility criteria. Machine-read from the registry text on this page, so it can be wrong. The registry text below and the trial team decide who can take part.

The trial looks at hospital medical units, not individual volunteers. It tests a unit-based approach to managing high blood pressure in patients admitted to hospital.

Age

18 years and older.

Sex

All sexes can join.

Disease stage

Patients on medical units that do not usually give step-down care. Their systolic blood pressure must reach 160 mmHg or higher during the hospital stay.

Main reasons for not taking part

• Under 18
• Hypertensive emergency, cardiac symptoms or active cardiovascular events (such as stroke or myocardial infarction)
• End-stage renal disease, dialysis or acute decompensated heart failure
• On the unit for more than 10 days, transferred in from the intensive care unit, or discharged within 24 hours of admission
• Pregnant and post-partum women

The registry criteria, word for word

What the trial wants to find out

The vast majority of the 36.2 million individuals admitted to U.S. hospitals are diagnosed with hypertension and experience an elevated blood pressure (BP) reading during hospitalization. There are no guidelines for managing asymptomatically elevated BPs in the inpatient setting, and growing observational evidence suggests that antihypertensive medication intensification increases harm. The proposed study tests whether a unit-based intervention (ACT-BP) can reduce antihypertensive medication intensification and provides information that is scientifically necessary for designing a cluster-randomized clinical trial that identifies the impact of intensification after experiencing an asymptomatically elevated BP on patient outcomes.

The 2 groups in the trial

• Intervention ArmTreatment being tested

  The ACT-BP protocol will be implemented in the intervention units. First, the study team will implement an order on the unit that prompts the nurses to follow the ACT-BP algorithm when a patient has an asymptomatic elevated BP between 160mmHg and 199mmHg. This protocol does not apply to patients who are experiencing hypertensive emergencies or cardiac symptoms. To increase adherence to the ACT-BP protocol, knowledge related to treating the potential underlying causes of an asymptomatically elevated BP and the current state of the evidence will be shared through posters, information sheets and knowledge sessions. At the the intervention hospital, the study team will provide caregivers (including physicians) with knowledge related to the state of the evidence for treating asymptomatically elevated BPs through emails, information sheets and one-pagers.

  Treatment: ACT-BP Intervention

• Control ArmNo study treatment, for comparison

  In the control units, care will continue as usual. At the the control hospital, caregivers (including physicians) will receive knowledge related to the state of the evidence for treating asymptomatically elevated BPs through an email.