What is optimal blood pressure target for antihypertensive treatment? A target randomised controlled trial emulation using big data

Dr Wan, Yuk Fai Eric   (Principal Investigator (PI))

Professor Wong Ian Chi Kei   (Co-Investigator)

Professor Yiu Kai Hang   (Co-Investigator)

Dr Fong Daniel Yee Tak   (Co-Investigator)

Professor Lam Cindy Lo Kuen   (Co-Investigator)

Dr Danaei Goodarz   (Co-Investigator)

Dr Emilsson Louise   (Co-Investigator)

Dr Yu Yee Tak Esther   (Co-Investigator)

Professor Chan Esther Wai Yin   (Co-Investigator)

Dr Chui Sze Ling Celine   (Co-Investigator)

24

2021-12-01

925260

What is optimal blood pressure target for antihypertensive treatment? A target randomised controlled trial emulation using big data

Antihypertensive, Big data, Blood pressure target, Hypertension, Target trial emulation

Others - Medicine, Dentistry and Health

18192571

Health and Medical Research Fund - Full Grant

2020

On-going

Objectives: To evaluate the optimal blood pressure target for antihypertensive treatment. Hypotheses: An intensive treatment target of systolic blood pressure(SBP)<130mmHg and diastolic blood pressure(DBP)<80mmHg is more effective in reducing 10-year cardiovascular disease(CVD) and all-cause mortality among patients with hypertension than other treatment targets (e.g. SBP<140mmHg and DBP<90mmHg). Design and Subjects: A target randomised controlled trial emulation using 10-year retrospective big cohort study. All patients aged ≥18 with clinically diagnosis of HT and SBP≥140mmHg or DBP≥90mmHg, without a diagnosis of diabetes mellitus, CVD and end-stage renal disease(ESRD), and were receiving care in the Hospital Authority primary care or specialist clinics in 2008 will be followed up until 31 December 2019. Main outcomes measures: The risk of CVD and all-cause mortality Instruments: None Interventions: An intensive treatment target of SBP<130mmHg and DBP<80mmHg or other treatment targets (e.g. SBP<140mmHg and DBP<90mmHg) emulation. Data analysis: Marginal structural models were used to compare different blood pressure targets. Pooled logistic models will be used to estimate the per-protocol effect of each blood pressure target on each HT complication and their composite adjusted for the baseline covariates and month of follow-up, and inverse probability weighting of a treatment change. Expected results: The findings of the proposed study will provide empirical evidence on the optimal antihypertensive blood pressure treatment target to inform clinicians and the public on the best practice in hypertension care for adults in primary care settings to prevent complications and mortality for the people in Hong Kong.