The Journal of Clinical Hypertension (Jun 2023)

Urinary proteomics combined with home blood pressure telemonitoring for health care reform trial—First progress report

  • Babangida S. Chori,
  • De‐Wei An,
  • Dries S. Martens,
  • Yu‐Ling Yu,
  • Natasza Gilis‐Malinowska,
  • Sani M. Abubakar,
  • Etubi A. Ibrahim,
  • Ojonojima Ajanya,
  • Olugbenga O. Abiodun,
  • Tina Anya,
  • Iyidobi Tobechukwu,
  • Godsent Isiguzo,
  • Hao‐Min Cheng,
  • Chen‐Huan Chen,
  • Chia‐Te Liao,
  • Gontse Mokwatsi,
  • Katarzyna Stolarz‐Skrzypek,
  • Wiktoria Wojciechowska,
  • Krzysztof Narkiewicz,
  • Marek Rajzer,
  • Jana Brguljan‐Hitij,
  • Tim S. Nawrot,
  • Kei Asayama,
  • Peter Reyskens,
  • Harald Mischak,
  • Augustine N. Odili,
  • Jan A. Staessen,
  • the UPRIGHT‐HTM Investigators

DOI
https://doi.org/10.1111/jch.14664
Journal volume & issue
Vol. 25, no. 6
pp. 521 – 533

Abstract

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Abstract High blood pressure (BP) and type‐2 diabetes (T2DM) are forerunners of chronic kidney disease and left ventricular dysfunction. Home BP telemonitoring (HTM) and urinary peptidomic profiling (UPP) are technologies enabling risk stratification and personalized prevention. UPRIGHT‐HTM (NCT04299529) is an investigator‐initiated, multicenter, open‐label, randomized trial with blinded endpoint evaluation designed to assess the efficacy of HTM plus UPP (experimental group) over HTM alone (control group) in guiding treatment in asymptomatic patients, aged 55–75 years, with ≥5 cardiovascular risk factors. From screening onwards, HTM data can be freely accessed by all patients and their caregivers; UPP results are communicated early during follow‐up to patients and caregivers in the intervention group, but at trial closure in the control group. From May 2021 until January 2023, 235 patients were screened, of whom 53 were still progressing through the run‐in period and 144 were randomized. Both groups had similar characteristics, including average age (62.0 years) and the proportions of African Blacks (81.9%), White Europeans (16.7%), women 56.2%, home (31.2%), and office (50.0%) hypertension, T2DM (36.4%), micro‐albuminuria (29.4%), and ECG (9.7%) and echocardiographic (11.5%) left ventricular hypertrophy. Home and office BP were 128.8/79.2 mm Hg and 137.1/82.7 mm Hg, respectively, resulting in a prevalence of white‐coat, masked and sustained hypertension of 40.3%, 11.1%, and 25.7%. HTM persisted after randomization (48 681 readings up to 15 January 2023). In conclusion, results predominantly from low‐resource sub‐Saharan centers proved the feasibility of this multi‐ethnic trial. The COVID‐19 pandemic caused delays and differential recruitment rates across centers.

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