Piedmont Heart Institute, Atlanta, GA (D.E.K.).
Institute for Medical Engineering and Science, Massachusetts Institute of Technology, Cambridge (F.M.).
Circulation. 2022 Mar 15;145(11):847-863. doi: 10.1161/CIRCULATIONAHA.121.057687. Epub 2022 Mar 14.
The clinical implications of hypertension in addition to a high prevalence of both uncontrolled blood pressure and medication nonadherence promote interest in developing device-based approaches to hypertension treatment. The expansion of device-based therapies and ongoing clinical trials underscores the need for consistency in trial design, conduct, and definitions of clinical study elements to permit trial comparability and data poolability. Standardizing methods of blood pressure assessment, effectiveness measures beyond blood pressure alone, and safety outcomes are paramount. The Hypertension Academic Research Consortium (HARC) document represents an integration of evolving evidence and consensus opinion among leading experts in cardiovascular medicine and hypertension research with regulatory perspectives on clinical trial design and methodology. The HARC document integrates the collective information among device-based therapies for hypertension to better address existing challenges and identify unmet needs for technologies proposed to treat the world's leading cause of death and disability. Consistent with the Academic Research Consortium charter, this document proposes pragmatic consensus clinical design principles and outcomes definitions for studies aimed at evaluating device-based hypertension therapies.
除了血压控制不良和药物依从性差的高患病率外,高血压的临床意义也促使人们对开发基于设备的高血压治疗方法产生兴趣。基于设备的治疗方法的扩展和正在进行的临床试验强调了在试验设计、实施和临床研究要素定义方面保持一致性的必要性,以允许试验可比性和数据可组合性。标准化血压评估方法、除血压以外的有效性措施以及安全性结果至关重要。高血压学术研究联盟(HARC)文件代表了心血管医学和高血压研究领域的领先专家之间不断发展的证据和共识意见,以及对临床试验设计和方法学的监管观点的整合。HARC 文件整合了高血压的基于设备的治疗方法的集体信息,以更好地应对现有挑战,并确定拟用于治疗世界主要死因和残疾的技术的未满足需求。与学术研究联盟章程一致,本文提出了用于评估基于设备的高血压治疗方法的研究的实用共识临床设计原则和结果定义。