IntroductionTelemedicine and blood pressure (BP) self-monitoring conduces to management of hypertension. Recent hypertension guidelines highly recommended single pill combination (SPC) for the initial treatment of essential hypertension. Based on this fact, an SPC-based telemedicine titration regimen with BP self-monitoring could be a better way in managing hypertension. This trial aims to elucidate whether telemedicine combined with BP self-monitoring is superior to self-monitoring alone during hypertension management.Methods and analysisThis study will be a multicentred, open-labelled, randomised controlled trial. A minimum sample of 358 hypertensive patients with uncontrolled BP from four centres will be included. The intervention group will include BP self-monitoring and tele-monitoring plus a free SPC-based telemedicine titration therapy for 6 months, they will be recommended to take BP measurements at least once every 7 days, in the meantime, researchers will call to give a consultation on lifestyle or titration advice once a fortnight. The control group will be required to self-monitor BP at the same time interval as intervention group, without any therapy change. Primary outcome of the trial will be the difference in systolic blood pressure at 6-month follow-up between intervention and control group, adjusted for baseline variables. Secondary outcomes such as BP control rate, major adverse cardiovascular events, medication adherence, quality of life will be investigated.Ethics and disseminationEthics approval was granted by Ethical Committee of Shanghai Tenth People’s Hospital (SHSY-IEC-4.1/20-194/01). The results will be disseminated in peer-reviewed literature, and to policy-makers and healthcare partners.Trial registration numberChiCTR2000037217.

Background Hypertension is a kind of clinical syndrome, characterized by the increase of systemic arterial pressure. There is a lack of identifiable triggers and predictors of hypertensive disease in response to treatment at rest and during exercise. In this study, a mathematical model was used to screen and compare the indicators and related changes at rest and during exercise between normotensive and hypertensive individuals. Methods Blood pressure and ultrasound-related indicators, blood biochemical indicators and metabolic compounds were collected and logistic regression model and Principal component analysis (PCA) were used to explore the differences of indexes at rest and in different exercise states in healthy and hypertensive patients. An indicator change map for hypertension is established. Results The results reveal that hypertension is not only related to oxidative stress, inflammatory reaction and fatty acid oxidation, but also involves various amino acid metabolism. The defined mathematical models and indicators changes during exercise might be helpful for early screening of hypertension and future studies are needed to explore their value on prevention and control of hypertension. Conclusion The research shows that the main regulation indicators at different exercise states differ significantly in the normal group and the hypertensive group. The key indicators of the normal group are blood pressure and ultrasound related indicators, while those of the hypertensive group are metabolites related to lactic acid metabolism, glycolysis, aerobic oxidation and lipid metabolism.

Objective To investigate the efficacy of early use of ivabradine in patients with acute myocardial infarction (AMI) after percutaneous coronary intervention (PCI). Methods Eighty patients with AMI were randomly divided into the ivabradine group and the control group. The ivabradine group was treated with ivabradine combined with metoprolol after PCI, while the control group was treated with metoprolol only. Both groups were treated continuously for 1 year. Echocardiography-derived parameters, heart rate, cardiopulmonary exercise testing (CPET) data, major adverse cardiac events (MACE) and myocardial markers were analyzed. Results The echocardiography-derived left ventricular ejection fraction was significantly higher in the ivabradine group than in the control group at 1 week, 3 months and 1 year after PCI. The heart rate of the ivabradine group was significantly lower than that of the control group at 1 week after PCI. The VO2max, metabolic equivalents, anaerobic threshold heart rate, peak heart rate, and heart rate recovery at 8 minutes of the ivabradine group were significantly higher than those of the control group at 1 year after PCI. The one-year total incidence of major adverse cardiac events was 10% in the ivabradine group, which was significantly lower than the 37.5% in the control group. The B-type natriuretic peptide of the ivabradine group was significantly lower than that of the control group on Day 2 and Day 3 after PCI. The troponin I level of the ivabradine group was significantly lower than that of the control group on Day 5 after PCI. Conclusion Early use of ivabradine in patients with AMI after PCI can achieve effective heart rate control, reduce myocardial injury, improve cardiac function and exercise tolerance, and reduce the incidence of major adverse cardiac events.