A Real World Research: Comparison of Precision and Experience Therapy for Hypertension, Diabetes or Hyperlipidemias

Study Overview
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Brief Summary
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The purpose of this study is to evaluate the effectiveness, safety and health economics of precise drug use strategies based on pharmacogenomics compared with traditional drug use strategies for cardiovascular related chronic diseases.

Detailed Description
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This study is a randomized controlled, single blind, multicenter clinical study. Beijing Chaoyang Hospital is the team leader, and director Liu Lihong is the project leader. The sub center is Daming County Street Town Health Center and Daming County Jiuzhi township health center. The team leader is responsible for the formulation, implementation and coordination of the research plan, and each sub center is responsible for the implementation of the specific study, patient management and research information feedback. Three project groups were set up in this study: primary hypertension, type 2 diabetes and hyperlipidemia. In each group, the control group and the experimental group were set up, and the patients in two pilot towns of Daming County were selected by cluster stratified random sampling. The control group received the treatment of local researchers according to the traditional medication strategy. The patients in the experimental group were treated with the drug regimen formulated by local researchers according to the results of their pharmacogenomic test reports. The subjects were single blind.

Official Title
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Real World Research Based on Genomics: Comparison of Precision and Experience Therapy for Chronic Cardiovascular and Cerebrovascular Diseases

Conditions
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Hypertension,Essential, Diabetes type2, Hyperlipidemias

Intervention / Treatment
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* Diagnostic Test: Gene detection of therapeutic drugs for chronic cardiovascular and cerebrovascular diseases
* Behavioral: Regular follow-up and patient education


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: They are 55 years old or above, with no gender restriction. They are permanent residents of Da-jie town and Jiu-zhi Township in Da-ming County. Patients who meet one of the following: A. Hypertension project group: Primary hypertension was definitely diagnosed, systolic blood pressure ≥ 140 millimeter of mercury, diastolic blood pressure ≥ 90 millimeter of mercury, or both after drug treatment. B.Type 2 Diabetes project group: Patients with type 2 diabetes mellitus (non insulin dependent diabetes mellitus) who were diagnosed as type 2 diabetes mellitus (NIDDM) and had HbA1c ≥ 7.0% after drug treatment before enrollment. C.Hyperlipidemia project group: Those who were diagnosed as hyperlipidemia and were treated with or without medication before enrollment. Patients who can provide real and reliable information related to drug treatment and efficacy evaluation Exclusion Criteria: Respondents who are not willing to fill in the true and reliable information form for any reason. Patients with infectious diseases or serious life-threatening diseases such as malignant tumors. Patients with severe liver and kidney function damage, affecting the choice of treatment drugs. Patients with incomplete data related to study evaluation such as any of following: A.The clinical data did not include systolic blood pressure, diastolic blood pressure, heart rate, glycosylated hemoglobin, fasting blood glucose, total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, triglyceride core efficacy evaluation indicators. B.The data related to adverse reactions required by clinical research can not be collected, including but not limited to the related drugs with adverse reactions, adverse reaction performance, time correlation, whether to stop suspicious drugs, and whether to stimulate adverse reactions by re-medication. C.The information of medication compliance score and quality of life score could not be provided for any reason.

Ages Eligible for Study
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Minimum Age: 55 Years
Maximum Age: 120 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Supportive Care
Allocation: Randomized
Intervention Model: Factorial Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Precision group<br>The subjects were tested for gene, and the corresponding therapeutic drugs were selected according to the results of gene detection. Regular follow-up was conducted according to the study design to evaluate the efficacy and adverse reactions. | Diagnostic Test: Gene detection of therapeutic drugs for chronic cardiovascular and cerebrovascular diseases<br>* According to the results of drug gene chip detection, we combined with the clinical characteristics of the patient to choose more suitable cardiovascular and cerebrovascular treatment drugs.<br>* Other names: Drug gene chip;Behavioral: Regular follow-up and patient education<br>* The subjects received regular follow-up and patient education.<br>|
| Active Comparator: Experience group<br>The subjects were treated with drugs selected by doctors according to their experience. Follow up was performed at the same frequency as the precision group to evaluate the efficacy and adverse reactions. | Behavioral: Regular follow-up and patient education<br>* The subjects received regular follow-up and patient education.<br>|
| No Intervention: Observation group<br>The subjects did not accept any intervention, including follow-up, especially regular evaluation of efficacy and adverse reactions. | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| change of systolic pressure | Change of systolic blood pressure from baseline | 3 months | 
| change of diastolic pressure | Change of diastolic blood pressure from baseline | 3 months | 
| change of glycosylated hemoglobin | Change of glycosylated hemoglobin from baseline | 3 months | 
| change of fasting blood glucose | Change of fasting blood glucose from baseline | 3 months | 
| change of total cholesterol | Change of total cholesterol from baseline | 3 months | 
| change of low density lipoprotein cholesterol | Change of low density lipoprotein cholesterol from baseline | 3 months | 
| change of triglyceride | Change of triglyceride from baseline | 3 months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Compliance rate of blood pressure | Change of the compliance rate of blood pressure from baseline | 12 months | 
| Compliance rate of glycosylated hemoglobin | Change of the compliance rate of glycosylated hemoglobin from baseline | 12 months | 
| Compliance rate of low density lipoprotein cholesterol | Change of the compliance rate of low density lipoprotein cholesterol from baseline | 12 months |