Remote Monitoring May Help Control High Blood Pressure
“We want to treat blood pressure at home,” she said, “not blood pressure in the office”.
People can’t assume that their blood pressure is under control just because they “feel good,” Stevens said.
“High blood pressure is the silent killer,” she says. And it not only contributes to heart disease and stroke, but also dementia, kidney disease, potentially blinding eye disease, and erectile dysfunction.
The New Findings – Published August 31 in Hypertension – are based on 450 patients with uncontrolled hypertension. Their readings were consistently equal to or greater than 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 participated in a one-year telemonitoring program. Members of the monitoring group received blood pressure monitors which uploaded 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 reduced to every two months.
Pharmacists, Margolis said, did more than change drug doses. They also discussed the management of side effects and lifestyle habits.
Within 18 months, the study found that patients in the monitoring group saw greater improvement in their blood pressure. And by the fifth year, 4.4% of them had suffered from a cardiovascular complication – compared to 8.6% of those in the standard care group.
Margolis said the results support taking regular home blood pressure measurements and the actions taken.
And that’s important, Stevens said, not just to catch stubbornly high numbers: some people have high readings in the doctor’s office, but not at home – what’s known as white coat hypertension. – and can end up being “over-processed”.
Right now, Margolis said, some health systems have telemonitoring programs similar to the one studied.
But, Steven adds, even without such technology, people can track their home numbers with a basic monitor and call their doctor if something goes wrong.
Remote monitoring and telephone visits have costs. Margolis and her team calculated them at around $ 1,500 per patient. But with fewer medical complications, it translated into a savings of money, at $ 1,900 per patient.
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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, Missouri, and volunteer medical expert, American Heart Association, Dallas;Hypertension, August 31, 2020, online
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