Treating elevated blood pressure during hospital stays to see if it changes outcomes

Is this trial a fit for you?

A plain-English reading of the study's rules. Only the study team can confirm whether you qualify.

What this trial studies

This unit-level intervention called ACT-BP removes standing orders that prompt automatic physician notification for elevated blood pressures, provides education about potential harms of treating asymptomatic inpatient BP elevations, and suggests alternatives such as more frequent monitoring and nonpharmacologic measures. The intervention is implemented at the hospital-unit level on general medical wards and outcomes include the rate of antihypertensive medication intensification and downstream patient events. The study is designed to generate the key feasibility and outcome data needed to plan a larger cluster-randomized trial that will determine whether inpatient intensification affects readmissions and adverse events. Enrollment excludes patients with hypertensive emergencies, active cardiovascular events, dialysis-dependent renal failure, pregnancy, very short or very long stays, ICU transfers, or systolic BP that remains below 160 mmHg during hospitalization.

Why it matters

Who can join: the full rules

Inclusion Criteria:

* At the unit level: Medical units that do not typically care for patients requiring step-down care.

Exclusion Criteria:

1. Patients less than 18
2. Patients experiencing hypertensive emergencies or cardiac symptoms
3. Patients with active cardiovascular events, such as

   * Stroke
   * Non-ST-elevation
   * Myocardial infarction
   * End-stage renal disease
   * Patients on dialysis
   * Those with acute decompensated heart failure

3\. Patients on the unit for more than 10 days

4\. Patients transferred in after being in the intensive care unit (ICU)

5\. Pregnant and post-partum women

6\. Patients discharged within 24 hours of admission

7\. Patients whose systolic BP remains below 160 mmHg during hospitalization.

Where it's running

• Cleveland Clinic Main Campus
  Cleveland, Ohio, United States Recruiting
• Cleveland Clinic Hillcrest
  Mayfield Heights, Ohio, United States Recruiting

Study contacts

• Principal investigator: Elizabeth Pfoh, PhD, MPH — The Cleveland Clinic
• Study coordinator: Elizabeth Pfoh, PhD, MPH
• Email: pfohe@ccf.org
• Phone: 12162963034

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How to take part

1. Review the eligibility criteria above with your treating physician.
2. Check the official listing on ClinicalTrials.gov for the latest contact details and recruitment status.
3. Contact the study coordinator or principal investigator to ask for pre-screening. Pre-screening is free and never obligates you to enroll.