Blood Pressure (Sep 2021)

Urinary proteomics combined with home blood pressure telemonitoring for health care reform trial: rational and protocol

  • Lutgarde Thijs,
  • Kei Asayama,
  • Gladys E. Maestre,
  • Tine W. Hansen,
  • Luk Buyse,
  • Dong-Mei Wei,
  • Jesus D. Melgarejo,
  • Jana Brguljan-Hitij,
  • Hao-Min Cheng,
  • Fabio de Souza,
  • Natasza Gilis-Malinowska,
  • Kalina Kawecka-Jaszcz,
  • Carina Mels,
  • Gontse Mokwatsi,
  • Elisabeth S. Muxfeldt,
  • Krzysztof Narkiewicz,
  • Augustine N. Odili,
  • Marek Rajzer,
  • Aletta E. Schutte,
  • Katarzyna Stolarz-Skrzypek,
  • Yi-Wen Tsai,
  • Thomas Vanassche,
  • Raymond Vanholder,
  • Zhen-Yu Zhang,
  • Peter Verhamme,
  • Ruan Kruger,
  • Harald Mischak,
  • Jan A. Staessen,
  • The UPRIGHT-HTM Investigators,
  • Coordinating, Logistic,
  • Recruiting, and,
  • Urinary Proteomics Centres,,
  • Advisors

DOI
https://doi.org/10.1080/08037051.2021.1952061
Journal volume & issue
Vol. 30, no. 5
pp. 269 – 281

Abstract

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Background Hypertension and diabetes cause chronic kidney disease (CKD) and diastolic left ventricular dysfunction (DVD) as forerunners of disability and death. Home blood pressure telemonitoring (HTM) and urinary peptidomic profiling (UPP) are technologies enabling prevention. Methods UPRIGHT-HTM (Urinary Proteomics Combined with Home Blood Pressure Telemonitoring for Health Care Reform [NCT04299529]) is an investigator-initiated 5-year clinical trial with patient-centred design, which will randomise 1148 patients to be recruited in Europe, sub-Saharan Africa and South America. During the whole study, HTM data will be collected and freely accessible for patients and caregivers. The UPP, measured at enrolment only, will be communicated early during follow-up to 50% of patients and their caregivers (intervention), but only at trial closure in 50% (control). The hypothesis is that early knowledge of the UPP risk profile will lead to more rigorous risk factor management and result in benefit. Eligible patients, aged 55–75 years old, are asymptomatic, but have ≥5 CKD- or DVD-related risk factors, preferably including hypertension, type-2 diabetes, or both. The primary endpoint is a composite of new-onset intermediate and hard cardiovascular and renal outcomes. Demonstrating that combining UPP with HTM is feasible in a multicultural context and defining the molecular signatures of early CKD and DVD are secondary endpoints. Expected outcomes The expected outcome is that application of UPP on top of HTM will be superior to HTM alone in the prevention of CKD and DVD and associated complications and that UPP allows shifting emphasis from treating to preventing disease, thereby empowering patients.

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