About this trial
This randomized trial compares two prescribing strategies to treat high blood pressure. One approach involves remote treatment informed by randomized trial evidence without regular monitoring of blood pressure ("fire and forget"), whilst the other involves usual care treatment with access to frequent blood pressure monitoring. The study will enrol participants with uncontrolled high blood pressure and randomize participants 1:1 to a "fire and forget" treatment group or a "more blood pressure monitoring" group for a total of 12 weeks. "Fire and forget" involves choosing the most appropriate treatment based on the highest quality evidence (randomized trial data), after which participants will stop measuring blood pressures until the end of study. The "more blood pressure monitoring" group will involve treatment as usual but with the access to frequent and high quality blood pressure monitoring.
The goal of this research is to:
1. determine which prescribing approach is more effective at lowering blood pressure after 12 weeks (end of study) 2. assess the safety, feasibility and acceptability of the two treatment approaches.
Eligibility criteria
Qualifiers
Written Informed consent
Adult aged ≥18 years
English proficiency
High BP defined as home SBP ≥135 or DBP ≥85 mmHg, either untreated or receiving one or two BP lowering drugs
Disqualifiers
Currently receiving three or more BP lowering drugs
Currently receiving an antihypertensive that is not one of the five major antihypertensive drug classes
Home SBP ≥155 mmHg for untreated participants
Home SBP ≥150 mmHg for participants on one BP lowering drug
Trial design
Treatments tested in this trial
- Fire and forget
- Usual care with more intensive BP monitoring