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NCT Number: NCT05937685

Reducing Blood Pressure in Patients With High Cardiovascular Risk

BP-REACH is a study of a team-based (pharmacist and health coach) program for lowering blood pressure for people with a prior stroke or heart attack in the Los Angeles Department of Health Services healthcare system.

The goal of this clinical trial is to test if this team based program is better at helping people reduce their blood pressure than usual care for people with prior heart attack or stroke. The main questions it aims to answer are:

* Do people in the REACH BP program have lower blood pressure at 12 months compared to those getting usual care? * Do people in the REACH BP program have better Life's Essential 8 scores and patient experience compared to those getting usual care?

Recruiting

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Key information

Conditions

Myocardial Infarction Brain Diseases Cardiovascular Diseases Central Nervous System Diseases Cerebrovascular Disorders Chronic Disease Disease Attributes Heart Diseases Hypertension Infarction Ischemia Myocardial Ischemia Necrosis Nervous System Diseases Pathologic Processes Pathological Conditions, Signs and Symptoms Stroke Vascular Diseases

Age range

35 year and older

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

Rancho Los Amigos National Rehabilitation Center, Downey, California, United States

Loading trial locations.

About this study

Hypertension is the leading contributor to preventable death and a major risk factor for recurrent cardiovascular events. To enhance BP control after stroke or myocardial infarction (MI), multilevel interventions are needed that incorporate health system and patient level factors.

BP-REACH aims to test the impact of an intervention on systolic blood pressure (SBP) for individuals with a history of stroke or MI in a randomized controlled trial in the Los Angeles Department of Health Services healthcare system. The primary outcome will be change in systolic blood pressure (SBP) at 12 months.

Hypothesis: Patients randomized to the intervention will achieve >2.4 mm Hg greater reduction in SBP at 1 year versus those randomized to usual care.

The study population will include participants from the inpatient and outpatient settings in Los Angeles County Department of Health Services health centers. The participants will be randomized in a 1:1 fashion to usual care or intervention, stratified by site, language and cardiovascular event (myocardial infarction, stroke). Outcomes will be collected from all participants at Baseline, 3 month and 12 month timepoints. The primary outcome is SBP.

Participants randomized to the intervention arm will receive additional a home blood pressure monitor, monthly phone calls from a health coach, and medication initiation and titration by a clinical pharmacist. The pharmacist will follow Los Angeles County Department of Health Services expected practices, which align with the ACC/AHA guidelines for blood pressure control and AHA guidelines for Secondary Stroke Prevention.

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • Patients of LA General Medical Center, Rancho Los Amigos, Olive Medical Center or Harbor-UCLA Medical Center with ischemic stroke, hemorrhagic stroke, or myocardial infarction
  • English or Spanish speaking
  • Systolic blood pressure (SBP) ≥ 130 mm Hg

Exclusion criteria

  • Age < 35 years
  • SBP < 130 mm Hg
  • Only speaks a language other than English or Spanish
  • Cannot provide informed consent due to dementia or aphasia

Treatment and study plan

BP REACH Intervention

Behavioral

Educational materials, written and digital. Home blood pressure monitor and self management education from BP REACH coach. Monthly coaching calls from BP REACH coach. Medication management by pharmacist

Primary outcomes

  1. Systolic blood pressure (SBP) mmHG

    Time frame: 12 months

    Collected by study staff using blood pressure monitor

Secondary outcomes

  1. Life's Essential 8

    Time frame: 12 months

    American Heart Association - survey measure. Score of 0-100, with 100 indicating a perfect score for cardiovascular health

  2. BMI (body mass index)

    Time frame: 12 months

    Height (cm) and weight (kg) collected by study staff, height divided by height indicating percentage of fat on the body

  3. Total cholesterol

    Time frame: 12 months

    Lab collection by study staff

  4. HgbA1c (hemoglobin A1C)

    Time frame: 12 months

    Lab collection by study staff

  5. Diet

    Time frame: 12 months

    Survey - California Health Interview Survey

  6. Physical activities

    Time frame: 12 months

    Survey - Behavioral Risk Factor Surveillance System Survey Questionnaire

  7. Smoking

    Time frame: 12 months

    Survey - PATH wave 1 survey

Study contacts

Contact information is provided by the study sponsor or research team.

Monica Ayala-Rivera

CONTACT

[email protected]

(323) 442-0934

Sponsors and collaborators

Lead sponsor

University of Southern California

Other

Collaborators

  • University of California, Irvine
  • University of California, Los Angeles

Registry information

Official study title

BP-REACH: Blood Pressure Disparities Reduction, Equity, and Access Among Safety Net Patients With Cardiovascular Health Risk

Acronym: BP-REACH

Important dates

Study start
2023
Primary completion
2026
Study completion
2026
First posted
Jul 10, 2023
Registry last updated
May 14, 2025

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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