title: Vascular Health Assessment of The Hypertensive Patients (VASOTENS) Registry: Study Protocol of an International, Web-Based Telemonitoring Registry for Ambulatory Blood Pressure and Arterial Stiffness.
abstract: BACKGROUND
  Hypertension guidelines recommend ambulatory blood pressure (ABP), central aortic pressure (CAP), and pulse wave velocity (PWV) as parameters for estimating blood pressure (BP) control and vascular impairment. Recent advances in technology have enabled devices to combine non-invasive estimation of these parameters over the 24-hour ABP monitoring. However, currently there is limited evidence on the usefulness of such an approach for routine hypertension management.
  
  
  OBJECTIVE
  We recently launched an investigator-initiated, international, multicenter, observational, prospective study, the Vascular health Assessment Of The Hypertensive patients (VASOTENS) Registry, aimed at (1) evaluating non-invasive 24-hour ABP and arterial stiffness estimates (through 24-hour pulse wave analysis, PWA) in hypertensive subjects undergoing ambulatory blood pressure monitoring (ABPM) for clinical reasons; (2) assessing the changes in estimates following treatment; (3) weighing the impact of 24-hour PWA on target organ damage and cardiovascular prognosis; (4) assessing the relationship between arterial stiffness, BP absolute mean level and variability, and prognosis; and (5) validating the use of a 24-hour PWA electronic health (e-health) solution for hypertension screening.
  
  
  METHODS
  Approximately 2000 subjects, referred to 20 hypertension clinics for routine diagnostic evaluation and follow-up of hypertension of any severity or stage, will be recruited. Data collection will include ABPM, performed with a device allowing simultaneous non-invasive assessment of 24-hour CAP and arterial stiffness (BPLab), and clinical data (including cardiovascular outcomes). As recommended by current guidelines, each patient will be followed-up with visits occurring at regular intervals (ideally every 6 months, and not less than once a year depending on disease severity). A Web-based telemedicine platform (THOLOMEUS) will be used for data collection. The use of the telemedicine system will allow standardized and centralized data collection, data validation by experts and counseling to remote centers, setup and maintenance of the Registry, and prompt data analysis.
  
  
  RESULTS
  First follow-up results are expected to be available in the next 2 years.
  
  
  CONCLUSIONS
  The results of the VASOTENS Registry will help define the normalcy thresholds for current and future indices derived from 24-hour PWA, according to outcome data, and will also provide supporting evidence for the inclusion of this type of evaluation in hypertension management.
  
  
  BACKGROUND
  Clinicaltrials.gov NCT02577835; https://clinicaltrials.gov/ct2/show/NCT02577835 (Archived by WebCite at http://www.Webcitation.org/6hzZBKY2Q).
authors.affiliation: Italian Institute of Telemedicine, Clinical Research Unit, Solbiate Arno, Italy. stefano.omboni@iitelemed.org.
authors.forename: Stefano
authors.identifier: http://orcid.org/0000-0002-7124-2096
authors.initials: S
authors.lastname: Omboni
authors.forename: Igor N
authors.identifier: http://orcid.org/0000-0002-2381-0351
authors.initials: IN
authors.lastname: Posokhov
authors.forename: Gianfranco
authors.identifier: http://orcid.org/0000-0001-9402-7439
authors.initials: G
authors.lastname: Parati
authors.forename: Alberto
authors.identifier: http://orcid.org/0000-0002-8311-2010
authors.initials: A
authors.lastname: Avolio
authors.forename: Anatoly N
authors.identifier: http://orcid.org/0000-0002-0543-3089
authors.initials: AN
authors.lastname: Rogoza
authors.forename: Yulia V
authors.identifier: http://orcid.org/0000-0002-1628-5093
authors.initials: YV
authors.lastname: Kotovskaya
authors.forename: Giuseppe
authors.identifier: http://orcid.org/0000-0002-8705-4911
authors.initials: G
authors.lastname: Mulè
authors.forename: Maria Lorenza
authors.identifier: http://orcid.org/0000-0002-4007-9441
authors.initials: ML
authors.lastname: Muiesan
authors.forename: Iana A
authors.identifier: http://orcid.org/0000-0002-8160-5612
authors.initials: IA
authors.lastname: Orlova
authors.forename: Elena A
authors.identifier: http://orcid.org/0000-0003-1843-5312
authors.initials: EA
authors.lastname: Grigoricheva
authors.forename: Ernesto
authors.identifier: http://orcid.org/0000-0001-7868-667X
authors.initials: E
authors.lastname: Cardona Muñoz
authors.forename: Parounak H
authors.identifier: http://orcid.org/0000-0002-6513-6772
authors.initials: PH
authors.lastname: Zelveian
authors.forename: Telmo
authors.identifier: http://orcid.org/0000-0001-9119-7774
authors.initials: T
authors.lastname: Pereira
authors.forename: João Manuel
authors.identifier: http://orcid.org/0000-0003-2261-1083
authors.initials: JM
authors.lastname: Peixoto Maldonado
keywords: arterial stiffness; augmentation index; blood pressure telemonitoring; central aortic pressure; hypertension; pulse wave velocity