Paperdoi:10.5646/ch.2026.32.e42
Cuffless 24-hour ambulatory blood pressure monitoring-guided antihypertensive titration in real-world clinical practice: a prospective non-randomized study
Clinical Hypertension 32:e42 (2026-10-01)
TL;DR
Single-centre, open-label, non-randomized prospective study of uncontrolled hypertension (Mar to Nov 2025). Physicians assigned CART BP pro-guided titration (n = 67) or usual care (n = 179). Primary endpoint: 24-h mean SBP at 6 months (ANCOVA, 10 covariates).
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Abstract
BackgroundTwenty-four-hour ambulatory blood pressure monitoring (ABPM) is the reference standard for diagnosing hypertension and assessing treatment response, but routine use remains limited by conventional cuff-based devices. We compared 6-month ambulatory blood pressure (BP) between cuffless 24-hour ABPM-guided titration and usual care in outpatient hypertension management.MethodsWe conducted a single-center, open-label, non-randomized prospective study of adults with uncontrolled hypertension between March and November 2025. Participants were assigned by the treating physician, without randomization, to CART BP pro-guided titration (CART BP arm, n = 67) or usual care (Control arm, n = 179). The primary endpoint was 24-hour mean systolic BP at 6 months, analyzed using analysis of covariance with 10 prespecified covariates. Sensitivity analyses addressed measured confounding, missing outcomes, and visit frequency.ResultsAmong 162 participants with a valid 6-month ABPM recording, the adjusted between-group difference in 24-hour systolic BP was -7.35 mmHg (95% confidence interval [CI], -12.03 to -2.67 mmHg; P P P = 0.04). Adjusted office systolic BP differed by -3.14 mmHg (95% CI, -9.25 to 2.96; P = 0.31). Adverse events were more frequent per participant (20.0% vs. 8.1%; P = 0.02); exposure-adjusted incidence rate ratios were 1.78 (95% CI, 0.87 to 3.65) per participant-visit and 2.75 (95% CI, 1.35 to 5.61) per person-year.ConclusionsIn this non-randomized study, a care pathway incorporating cuffless 24-hour ABPM was associated with lower 24-hour ambulatory systolic BP at 6 months compared with usual care, whereas office systolic BP did not differ significantly between arms. Given the non-randomized design, these findings are hypothesis-generating and require confirmation in a randomized trial.Trial registrationClinicalTrials.gov Identifier: NCT07454148.
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APA
Cha, J. J., Kim, M. N., Kim, S. R., Park, J. H., Joo, H. J., & Yu, C. W. (2026). Cuffless 24-hour ambulatory blood pressure monitoring-guided antihypertensive titration in real-world clinical practice: a prospective non-randomized study. Clinical Hypertension 32:e42. https://doi.org/10.5646/ch.2026.32.e42
BibTeX
@article{cha2026cuffless,
title = {{Cuffless 24-hour ambulatory blood pressure monitoring-guided antihypertensive titration in real-world clinical practice: a prospective non-randomized study}},
author = {Cha, J. J. and Kim, M. N. and Kim, S. R. and Park, J. H. and Joo, H. J. and Yu, C. W.},
year = {2026},
journal = {Clinical Hypertension 32:e42},
doi = {10.5646/ch.2026.32.e42}
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