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The William Harvey Research Institute - Faculty of Medicine and Dentistry

New study shows personalised approach starting with small drug doses adjusted according to progress improved treatment of hypertension during COVID lockdown

A new study published in the Journal of the American Heart Association shows that personalising the dose of amlodipine using novel doses can improve blood pressure (BP) control and achieve high adherence in participants measuring their BP at home.

BP-Covid study smartphone app

Covid-BP study smartphone app.

The study describes the final results of the PERSONAL-CovidBP clinical trial, led by researchers at the William Harvey Research Institute at Queen Mary University of London. It showed that they could remotely recruit, sort participants according to BP control and then use a precision care solution, CLM-HT01, to successfully control BP whilst minimizing side effects and supporting medication adherence in participants with primary hypertension.

Hypertension is the leading preventable cause of severe illness and premature death worldwide. Despite being a standard BP lowering drug, ~20% of patients stop amlodipine after a single prescription largely due to side-effects, such as ankle swelling which is strongly related to dose. CLM-HT01 is a drug-device combination product, in development by leading TechBio company Closed Loop Medicine Ltd. The technology links proprietary software as a medical device (SaMD) with amlodipine. 

Participants were given a dedicated smartphone app to record their home blood pressure readings, drug dose and any side-effects.  Blood pressure fell significantly and quickly, most participants achieved BP control with minimal side effects, including those unable to take the usual doses of amlodipine. Using the app was popular among participants and they rewarded the researchers by faithfully recording their BP over the three months of the study.  Whilst most did well, those who could not cope with any amlodipine continued to use the app for helping to control their BP. The findings build on preliminary results published in the Journal of the American College of Cardiology, and the Journal of Human Hypertension.

Dr. David Collier, the lead trial investigator from Queen Mary University of London, said: “We are incredibly pleased to have the final results from the PERSONAL-CovidBP trial published in the JAHA, a leading open access scientific journal.” He added: “We wanted to use personalized dosing of amlodipine, and had worked with our patients to develop a digital platform to allow this. Working remotely due to COVID we still managed to recruit, triage (selected participants according to home blood pressure), and then treat patients with this novel approach. Often starting with very small doses, empowering participants to share both wanted and unwanted effects of medication helped us to work together to reduce blood pressure while minimizing any side-effects. Some participants who had never tolerated full doses of any blood pressure medication got control for the first time.”

PERSONAL-CovidBP was part-funded by Innovate UK and run by the William Harvey Clinical Research Centre at Queen Mary University of London, part of the NIHR Barts Biomedical Research Centre

Further information

  • Research paper: Collier DJ, Taylor M, Godec T, Shiel J, James R, Chowdury Y, Ebano P, Monk V, Patel M, Pheby J, Pheby R, Foubister A, David C, Saxena M, Richardson L, Siddle J, Timlin G, Goldsmith P, Deeming N, Poulter NR, Gabe R, McManus RJ, Caulfield MJ. Personalized Antihypertensive Treatment Optimization With Smartphone-Enabled Remote Precision Dosing of Amlodipine During the COVID-19 Pandemic (PERSONAL-CovidBP Trial). J Am Heart Assoc. 2024 Feb 7:e030749. doi: 10.1161/JAHA.123.030749. Epub ahead of print. PMID: 38323513.



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