Efficacy of Telemedicine in Hypertension Care Through Home Blood Pressure Monitoring and Videoconferencing: Randomized Controlled Trial

Abstract

Background The burden of time is often the primary reason why patients discontinue their treatment. Telemedicine may help patients adhere to treatment by offering convenience. Objective This study examined the efficacy and safety of telemedicine for the management of hypertension in Japan. Methods Patients with uncomplicated hypertension were recruited through web advertising between November 2015 and February 2017. They were then screened, stratified by office systolic blood pressure (SBP), and randomized into two groups: usual care (UC) and telemedicine. The telemedicine group used a 3G network–attached home blood pressure (BP) monitoring device, consulted hypertension specialists from an academic hospital through web-based video visits, and received prescription medication by mail for 1 year. The UC group used the same BP monitoring device but was managed using self-recorded BP readings, which included their diary entries and office BP taken in a community practice setting. Results Initial screening was completed by 99 patients, 54% of whom had untreated hypertension. Baseline BP was similar between the groups, but the weekly average SBP at the end of the 1-year study period was significantly lower in the telemedicine group (125, SD 9 mmHg vs 131, SD 12 mmHg, respectively; P=.02). SBP in the telemedicine group was 3.4 mmHg lower in the morning and 5.8 mmHg lower in the evening. The rate of SBP control (135 mmHg) was better in the telemedicine group (85.3% vs 70.0%; P=.01), and significant adverse events were not observed. Conclusions We present evidence suggesting that antihypertensive therapy via home BP telemonitoring and web-based video visits achieve better BP control than conventional care and is a safe treatment alternative that warrants further investigation. Trial Registration UMIN-CTR UMIN000025372; https://tinyurl.com/47ejkn4b

How Is Telehealth Currently Being Utilized to Help in Hypertension Management within Primary Healthcare Settings? A Scoping Review

“…Patients using telehealth have seen significant improvements in clinical outcomes such as blood pressure control, which are comparable to patients receiving in-person care [40]. Telehealth can also support team-based care delivery and benefit patients and healthcare professionals by increasing opportunities for communication, engagement, and monitoring outside a clinical setting [41].…”

Current situation of telemedicine research for cardiovascular risk in Japan

“… Average home BP decreased from 151/87 mmHg to 120/71 mmHg over 4 years. Yatabe et al, 2021 [ 20 ] Hypertension RCT Standard care group ( n = 48) Intervention group ( n = 49) 53 years 53 years 12 months Intervention group received web-based counseling based on home BP levels. Average home systolic BP during the last week of the 1-year study was significantly lower in telemedicine group (125 mmHg in telemedicine group versus 131 mmHg in the standard care group; P = 0.02).…”

“…There are several other studies that assessed the efficacy of telemedicine in hypertensive patients. Yatabe et al recruited 99 patients with uncomplicated hypertension and randomized them to either telemedicine group or standard care group [ 20 ]. All the patients were instructed to measure BP twice every morning (before having a breakfast) and every evening (before going to bed) by using a uniform, validated automatic sphygmomanometer.…”

Potential effects of virtual interventions for menopause management: a systematic review

“…14 With the ongoing COVID-19 pandemic, which restricts people's social and in-person contact, there is now a major need for virtual interventions to mitigate health issues 15 such as pain, 16 diabetes, 17 and hypertension. 18 Although virtual interventions have been used as an alternative to traditional health service, an empirical understanding of their effects, benefits, and barriers is warranted. The purpose of this systematic review is to summarize existing literature on the evaluation of virtual interventions to facilitate the menopausal transition.…”