Clinical trial NCT02744456 (early phase 1, status: completed)
Conditions: hypertension, high blood pressure
ICD codes: I15.0, I97.3, K76.6, P29.2, G93.2, H40.053, I10
Drugs: losartan, amlodipine, hydrochlorothiazide
SMILES: CCCCC1=NC(Cl)=C(CO)N1CC1=CC=C(C=C1)C1=CC=CC=C1C1=NNN=N1, COC(=O)C1=C(C)NC(C)=C(C1C1=CC(=CC=C1)[N+]([O-])=O)C(=O)OC(C)(C)CN(C)CCC(C1=CC=CC=C1)C1=CC=CC=C1, COCCC1=CC=C(OCC(O)CNC(C)C)C=C1
Eligibility criteria:

        Inclusion Criteria:

          -  Age 21 to 80 years.

          -  History of physician-diagnosed hypertension.

          -  Currently not treated with antihypertensive medication but with consensus (from
             patient and his/her physician; patients with elevated ABPM who are not on treatment
             will be considered eligible irrespective of office BP if the patient's physician is in
             agreement with a trial of BP medications) that antihypertensive medication should be
             initiated; or being treated with one antihypertensive medication.

          -  No history of suspected or confirmed white coat hypertension (elevated clinic BP but
             non-elevated out-of-clinic BP either by home BP monitoring or ABPM).

          -  Easy access to and regular use of e-mail as they will need to be able to respond to
             Qualtrics surveys at regular intervals during the self-monitoring period.

          -  Established relationship with an accessible primary care provider.

          -  Primary care provider gives permission to participation in an N-of-1 trial.

        Exclusion Criteria:

          -  Severe hypertension (office BP = 180/110 mm Hg).

          -  History of myocardial infarction, heart failure, atrial fibrillation, or chronic
             kidney disease as these patients have guideline recommended indications for specific
             classes of BP medications.

          -  Electrolyte abnormality; if no electrolyte panel is available in the prior 6 months,
             then one will be ordered for purposes of the study.

          -  Known drug allergy or intolerance to angiotensin receptor blocker, calcium channel
             blocker, or thiazide diuretic.

          -  Prescribed BP medication for indication other than hypertension (e.g., migraine
             headache prophylaxis, enlarged prostate).

          -  Primary care provider permission not obtained.

          -  Non-English speaking.

          -  No regular (daily) access and use of e-mail as participants will need to be able to
             respond to emailed links to surveys for completion of self-monitoring symptoms.

          -  Unable to provide informed consent or adhere to study protocol due to cognitive
             impairment, mental illness, or other reasons.

          -  Unable to monitor BP at home using an automatic BP machine due to physical or mental
             impairments.

          -  Unable to track side effects of medications due to physical or mental impairments
             including literacy problems.

          -  Arm circumference <9 inches or >17 inches as these sizes do not accommodate the range
             of BP cuff sizes that are available for the automatic BP machine.

          -  Unavailable for follow-up during the study period due to severe medical illness or
             other reasons.