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Cardiovascular DiseaseHAPPYLondonNCT01911910

Heart Attack Prevention Programme for You (HAPPY) London

A study of Cardiovascular Disease, run by Queen Mary University of London at 1 site in United Kingdom.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

Diseases of the heart and blood vessels, such as heart attacks and strokes, are very common and can lead to severe disability or death. Changes in the body leading to heart attacks and strokes usually develop over decades as a result of smoking, diet, and lack of exercise, obesity, diabetes and high blood pressure. Read more about this study

Who is it for?
Ages 40 to 74 years
Conditions the study is for
Cardiovascular Disease
Could I receive a placebo?
No, everyone receives an active treatment
How many people
402 participants
Where
1 siteUnited Kingdom
Study dates
Jun 2013to May 2015
Phase
Interventional
Are there results?
Yes, posted in the registrySummary in the doctors' view

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 40 to 74 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Subjects will be enrolled following an informed consent. The subject will be able to understand and comply with protocol requirements, instructions and protocol-stated restrictions
  • Subjects will be between 40 and 74 years of age
  • Subjects will have unrestricted access to the Internet
  • Subjects will be sufficiently fluent in English language.
  • Subjects will have an estimated intermediate to high risk for CV events based on the web-based pre-screening tool (www.happylondon.info), which is based on the nonlaboratory Framingham risk score (>10% 10 year cardiovascular risk)

Who cannot join

  • History of stroke or transient ischaemic attack (TIA)
  • Cardiac sounding chest pain requiring further investigations
  • Current life threatening conditions other than vascular disease (e.g. very severe chronic airways disease, HIV positive, life-threatening arrhythmias) that may prevent a subject from completing the study
  • Only for subgroup undergoing cardiac contrast-enhanced magnetic resonance studies: Any contraindication to a contrast-enhanced magnetic resonance study, such as known allergies to gadolinium-based contrast agents, severe claustrophobia, pacemakers, defibrillators, etc

Trial locations and contacts

1 site in 1 country.

United Kingdom1 site
  • Centre for Advanced Cardiovascular Imaging, William Harvey Research Institute, Queen May University of London

    London, E2 9JX

Other trials in United Kingdom

About this study

Diseases of the heart and blood vessels, such as heart attacks and strokes, are very common and can lead to severe disability or death. Changes in the body leading to heart attacks and strokes usually develop over decades as a result of smoking, diet, and lack of exercise, obesity, diabetes and high blood pressure. Changes in lifestyle and diet can significantly reduce the risk of heart diseases. General Practitioners invite 40 to 74 year-olds who have no known heart disease to take part in the NHS Health Check, which measures each person's individual risk of developing a heart attack or stroke and encourages them in a face-to-face meeting to take part in programmes to help them to give up smoking, lose weight etc. where necessary. In this new clinical trial the investigators will test whether computer-tailored electronic (e)-coaching via email and the internet can help people make the necessary changes in their lifestyle to reduce the risk of heart attacks and strokes.

Read the detailed description

Heart Attack Prevention Programme for You London (HAPPY London) will be conducted as a randomised controlled trial comparing the use of tailored e-coaching in addition to the standard of care vs. standard care alone. Standard care is defined as the care that would be offered by the NHS Health Check programme through the NHS primary care. We will use a range of established and novel cardiovascular markers to determine the clinical and cost effectiveness of e-coaching and gain pathophysiological insight into how lifestyle modifications affect the cardiovascular system. These measures include cardiovascular magnetic resonance imaging (CMR), aortic stiffness parameters, vascular ultrasound and other biomarkers of CV disease risk.

Intervention

The HAPPY London web-based tool will provide the participant with an individualised score for their lifestyle and 10 year CV risk score, based on the modified Framingham score and the UK specific QRisk Score, and provide tailored advice and education on the suboptimal factors. Ideal targets will be set and the information will be updated at 3 and 6 months allowing the participant to view their progress. Weekly emails with brief health and lifestyle advice will be sent to encourage healthier behaviour based on clinical studies or topical issues in the media. Links to social networks, such as Facebook posting and the ability to allow chosen 'buddies' from family or friends to view their progress will aim to further encourage healthier behaviour.

The study involves the recruitment of 400 adults between the age of 40 and 74 years who have a moderate to high 10-year CV risk score (Estimated 10 year CV risk >10%). Half of the study group will receive use of the e-coaching in addition to standard care allocated randomly stratified according to either moderate (QRisk between 10 and 20%) or high risk (QRisk more than or equal to 20%). The initial screening will take place on the www.happylondon.info web-based 'mini-check' questionnaire. Potential participants will then be seen at a physical screening visit to confirm eligibility. 3 subsequent visits will take place over 6 months; baseline, 3 month and 6 month follow up. A subgroup of the study population (65 from each intervention arm thus totalling 130 participants ) will also have a baseline and follow up cardiovascular magnetic resonance (CMR) imaging. Assessment will be performed using a variety of measures through questionnaires, blood pressure (BP) checks, blood tests, ultrasound scans, oscillometric method to assess pulse wave velocity and pulse wave analysis and CMR multi-parametric scanning.

The primary aim of this study is to assess the clinical effectiveness of individualised, continuous electronic (e-) coaching to support a healthier lifestyle as a primary prevention tool to reduce the CV risk and improve the quality of life in asymptomatic individuals with intermediate to high 10 year CV risk.

Other questions that we aim to answer are:

  1. Is computer-tailored e-coaching cost-effective in the short-term (clinical trial period) and during the long-term (decision analysis modelling)
  2. What are the associations of personality traits, economic preferences, and sociocultural factors with the achieved lifestyle modifications and changes in the cardiovascular phenotype?
  3. What is the relationship between changes observed in markers derived from our multi-parametric cardiovascular magnetic resonance imaging protocols following lifestyle changes?
  4. How frequent are silent myocardial infarctions in a typical NHS Health Check population?
  5. Do treatment effects differ between ethnic groups?
Being tested
Electronic coaching plus standard care
Keywords
primary prevention, Cardiovascular disease, Cardiovascular magnetic resonance (CMR), Electronic coaching (e-coaching)
Medical subject headings
Cardiovascular Diseases

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Electronic coaching plus standard careBehavioural

    Also called Electronic coaching, E-Coaching, HAPPY E-Coaching

    The HAPPY London web-based tool will provide the participant with an individualised score for their lifestyle and 10 year CV risk score, based mainly on the modified Framingham score, and provide tailored advice and education on the suboptimal factors. Ideal targets will be set and the information will be updated at 3 and 6 months allowing the participant to view their progress. Weekly emails with brief health and lifestyle advice will be sent to encourage healthier behaviour based on clinical studies or topical issues in the media. Links to social networks, such as Facebook posting and the ability to allow chosen family and friends to view their progress will aim to further encourage healthier behaviour.

Study groups in NCT01911910
Study groupRoleWhat they receive
Standard careNo interventionUsual care that would be provided by the NHS Health Check or equivalent.
Electronic coaching plus standard careExperimentalTailored coaching for participants randomised to use the HAPPY e-coaching tool. Access to lifestyle and heart health scores and personalised advice to improve suboptimal behaviour.
Receives: Behavioral: Electronic coaching plus standard care

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Change in Pulse Wave Velocity (PWV)

    Change in aortic stiffness using a Vicorder device measured in m/s

    Measured: Assessed at Baseline visit, 3 months and 6 months; Month 6 reported

Secondary outcomes (17)
  1. Change in Carotid Intima Media Thickness CIMT

    carotid intima media thickness CIMT as measured by ultrasound

    Measured: Assessed at Baseline visit, 3 months and 6 months; Month 6 reported

  2. Change in Quality of Life

    Lifestyle, quality of life and physical activity questionnaires. Questionnaires SF-36, EQ5D-3L, RPAQ.

    Measured: Assessed at Baseline visit, 3 months and 6 months; Data not reported as full analysis not done due to time constraints

  3. Pulse Wave Velocity by CMR

    Change in aortic stiffness as measured by CMR derived aortic pulse wave velocity measured in m/s

    Measured: Baseline and 6 month. Data not reported as full analysis not possible due to time and resource limitations.

  4. Aortic Distensibility by Cardiovascular Magnetic Resonance (CMR)

    CMR will be performed on 65 participants in the treatment and 65 in the standard care group.

    Change in aortic stiffness - aortic distensibility (mmHg-1, CMR)).

    Measured: Baseline and 6 month

  5. Left Ventricular Mass by CMR

    Change in LV mass index (g/m2, CMR).

    Measured: Baseline and 6 month

  6. Left Ventricular Ejection Fraction by CMR

    LV end-diastolic and end-systolic volume indices, (ml/m2, CMR), LV EF (%, CMR).

    Measured: Baseline and 6 month

  7. Myocardial Fibrosis by CMR

    Extent and change in diffuse myocardial fibrosis (extracellular volume fraction measured as a %, derived from CMR imaging)

    Measured: Baseline and 6 month. Baseline and 6 month. Data not reported as full analysis not possible due to time and resource limitations.

  8. Diastolic Function by CMR

    Diastolic function (strain and strain rate in % and s-1, respectively derived from CMR imaging data).

    This is a measure of how stiff the main chamber of the heart is. The software to analyse these data will be available in the future.

    The raw images from the scan will be used for future analysis once software for this assessment is developed. Our group is working on developing this tool.

    Measured: Baseline and 6 month. Baseline and 6 month. Data not reported as full analysis not possible due to time and resource limitations.

  9. Change in Framingham Risk Score

    Assessment of cardiovascular risk based on the Framingham algorithm. Minimum value 0% and maximum value theoretically 100%. Higher score means worse predicted outcome.

    Assessment of 10-year cardiovascular risk score based on the Framingham population derived algorithm.

    Minimum value 0% and maximum value theoretically 100%. Higher score means worse predicted outcome.

    Measured: Assessed at Baseline visit, 3 months and 6 months; Month 6 reported

  10. Change in QRisk Score

    Assessment of cardiovascular risk score based on the QRisk risk score. Minimum value 0% and maximum value theoretically 100%. Higher score means worse predicted outcome.

    Assessment of cardiovascular risk score based on the UK standardised using the QRISK2 algorithm (www.qrisk.org).

    Minimum value 0% and maximum value theoretically 100%. Higher score means worse predicted outcome.

    Measured: Assessed at Baseline visit, 3 months and 6 months; Month 6 reported

  11. Change in Total Cholesterol to HDL Ratio

    Ratio of Total cholesterol to HDL from blood test for lipid profile. Change in the ratio of total cholesterol to HDL cholesterol ratio as assessed though cholesterol blood test. Negative value suggests an improvement.

    Measured: Assessed at Baseline visit, 3 months and 6 months; Month 6 reported

  12. Change in LDL Cholesterol

    Bloods for lipid profile. Change in the level of LDL cholesterol as assessed though cholesterol blood test. Negative value for change suggests an improvement.

    Measured: Assessed at Baseline visit, 3 months and 6 months; Month 6 reported

  13. Change in Glucose Levels

    Fasting glucose bloods. This is an assessment for presence of diabetes and control of blood sugar levels on the day of the test.

    Change in the blood glucose level as measure on the day of the visit as a measure of blood sugar level. Negative value would suggest an improvement.

    Measured: Assessed at Baseline visit, 3 months and 6 months; Month 6 reported

  14. Change in hsCRP

    baseline and change in hsCRP blood test. hsCRP is measured through a blood test and is a marker of inflammation. Change in the hsCRP level though a blood test. Negative value suggests an improvement.

    Measured: Assessed at Baseline visit, 3 months and 6 months; Month 6 reported

  15. Change in Physical Activity

    Lifestyle, quality of life and physical activity questionnaires. Questionnaires SF-36, EQ5D-3L, RPAQ

    Measured: Assessed at Baseline visit, 3 months and 6 months; Month 6 reported

  16. Change in Systolic Blood Pressure

    Change in systolic blood pressure measured during sitting position

    Measured: Assessed at Baseline visit, 3 months and 6 months; Month 6 reported

  17. Change in Diastolic Blood Pressure

    Change in diastolic blood pressure measure during sitting position.

    Measured: Assessed at Baseline visit, 3 months and 6 months; Month 6 reported

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted30 Jul 2013 (estimated)
  2. Study startJun 2013
  3. Primary completionMay 2015
  4. Study completionMay 2015

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Prevention
Allocation
Randomised
Intervention model
Parallel groups
Masking
Single blind
Who is masked
Outcomes assessor
Enrolment
402 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT01911910
Sponsor's protocol ID
ReDa: 007711
Acronym
HAPPYLondon
Status last verified
Sep 2020
First submitted
22 Jul 2013
Last updated
12 Oct 2020
Data monitoring committee
No

Publications

  • Khanji MY, Balawon A, Boubertakh R, Hofstra L, Narula J, Hunink M, Pugliese F, Petersen SE. Personalized E-Coaching in Cardiovascular Risk Reduction: A Randomized Controlled Trial. Ann Glob Health. 2019 Jul 12;85(1):107. doi: 10.5334/aogh.2496.

    PubMed 31298823
  • Khanji MY, Stone IS, Boubertakh R, Cooper JA, Barnes NC, Petersen SE. Chronic Obstructive Pulmonary Disease as a Predictor of Cardiovascular Risk: A Case-Control Study. COPD. 2020 Feb;17(1):81-89. doi: 10.1080/15412555.2019.1694501. Epub 2019 Dec 13.

    PubMed 31833441

Questions about this trial

What is this clinical trial studying?

A study of Cardiovascular Disease, run by Queen Mary University of London at 1 site in United Kingdom.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 5 inclusion and 4 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 12 Oct 2020. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in United Kingdom. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

Yes. Results are posted in the registry (first posted 12 Oct 2020). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Change in Pulse Wave Velocity (PWV) (time frame: Assessed at Baseline visit, 3 months and 6 months; Month 6 reported). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT01911910, which also lists 2 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 12 Oct 2020.

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