Remote Monitoring May Help Control High Blood Pressure

“We want to treat the home blood pressure,” she said, “not the office blood pressure.”
People cannot assume their blood pressure is under control just because they “feel fine,” Stevens stressed.
“High blood pressure is the silent killer,” she said. And it contributes not only to heart disease and stroke, but also to dementia, kidney disease, potentially blinding eye disease and erectile dysfunction.
The new findings — published Aug. 31 in Hypertension — are based on 450 patients with uncontrolled high blood pressure. Their readings were consistently at or above 140/90 mm Hg (or 130/80 mm Hg, if they had diabetes or kidney disease).
Half were randomly assigned to stick with standard care, while the rest took part in a one-year telemonitoring program. Those in the telemonitoring group were given blood pressure monitors that sent their readings to a secure website. For the first six months, they had phone calls with a pharmacist every two weeks, until their blood pressure was under control. Then the visits were trimmed to every two months.
The pharmacists, Margolis said, did more than tweak medication doses. They also discussed managing side effects and lifestyle habits.
Over 18 months, the study found, patients in the telemonitoring group saw a greater improvement in their blood pressure. And at year five, 4.4% of them had suffered a cardiovascular complication — compared to 8.6% of those in the standard-care group.
Margolis said the findings support taking regular home blood pressure readings and acting on them.
And that’s important, Stevens said, not only to catch stubbornly high numbers: Some people have elevated readings in the doctor’s office, but not at home — what’s known as white-coat hypertension — and can end up being “overtreated.”
Right now, Margolis said, some health systems do have telemonitoring programs similar to the one studied.
But, Steven added, even without such technology, people can track their numbers at home with a basic monitor and call their doctor with any concerns.
Telemonitoring and phone visits do have costs. Margolis and her team calculated them to be about $1,500 per patient. But with fewer medical complications, that translated into money saved, at $1,900 per patient.

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Sources
SOURCES: Karen Margolis, MD, MPH, executive director, research, HealthPartners Institute, Minneapolis; Tracy Stevens, MD, professor, medicine, University of Missouri-Kansas City School of Medicine, cardiologist, Saint Luke’s Cardiovascular Consultants and Saint Luke’s Mid-America Heart Institute, Kansas City, Mo., and volunteer physician expert, American Heart Association, Dallas;Hypertension, Aug. 31, 2020, online


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