Saves the questions and what to expect into your notes, next to the visit they belong to.
Keep this study
Lead
Hospital Israelita Albert Einstein
With
Ministry of Health, Brazil
Age
50–any
Sex
ALL
Healthy volunteers
Not accepted
You may be eligible if
Systolic Blood Pressure (SBP) between 130 and 180 mm Hg:
* 130 to 150 mm Hg (if on 0-4 medications)
* 130 to 160 mm Hg (if on 0-3 medications)
* 130 to 170 mm Hg (if on 0-2 medications)
* 130 to 180 mm Hg (if on 0-1 medications)
Type 2 diabetes
To be considered as having a high cardiovascular risk, including AT LEAST ONE of the following factors:
1. Established cardiovascular disease (CVD), including:
* Coronary artery disease: previous myocardial infarction, previous acute coronary syndrome, previous percutaneous coronary intervention, previous coronary artery bypass graft surgery, or at least 50% stenosis in a main coronary artery associated with typical angina pectoris; or
* Cerebrovascular disease: previous stroke (except those events caused by intracranial aneurysm or arteriovenous malformation) or previous transient ischemic attack (TIA), stable for at least 2 weeks preceding inclusion in the study; or
* Carotid artery disease: previous carotid endarterectomy, previous percutaneous intervention with carotid stent implantation, or stenosis of at least 50% in a carotid shown by the Doppler ultrasonography, CT angiography or MR angiography; or
* Peripheral artery disease: prior surgical or percutaneous revascularization of a peripheral artery, limb amputation due to vascular cause, abdominal aortic aneurysm ≥ 5 cm (with or without prior surgical or percutaneous repair), or stenosis of at least 50% in a peripheral artery associated to intermittent claudication.
2. Subclinical CVD, including:
* Coronary calcium score ≥ 300 Agatston units; or
* Ankle-brachial index ≤ 0.90 in the last two years; or
* Left ventricular hypertrophy on the electrocardiogram, echocardiogram or other cardiac imaging exam in the last two years.
3. Chronic kidney disease (CKD):
▪ Definition of CKD: glomerular filtration rate (GFR) between 20 and 59 ml/min/1.73m2 calculated by the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI).
* Active smoking: Defined as regular use of cigarettes or other tobacco products, such as cigars and pipe, in the last six months;
* Dyslipidemia: Defined as LDL cholesterol \> 70 mg/dL or non-HDL cholesterol \> 100 mg/dL in patients with previous CVD; or LDL cholesterol \> 100 mg/dL or non-HDL cholesterol \> 130 mg/dL in patients without previous CVD; or Triglycerides \> 200 mg/dL or HDL \< 40 mg/dL regardless of treatment; or use of statins or other lipid lowering medication; or
* Age ≥ 75 years
You may not be if
Refusal to provide written informed consent
Body mass index \> 45 kg/m2
Known secondary cause of hypertension
Severe renal dysfunction with GFR \< 20 mL/min/1.73m2 calculated by the CKD-EPI equation
Angina at rest Class IV Canadian Cardiovascular Society (CCS)
Acute coronary syndrome in the last six months
Symptomatic heart failure Class IV New York Heart Association (NYHA) or ejection fraction \< 35% on Doppler echocardiography in the last six months
Factors that at the research team´s judgment may limit adherence to the intervention and study protocol, including, but not limited to, the following examples:
* Recent history of alcohol and illicit drug abuse
