Evidence and Recommendations on the Use of Telemedicine for the Management of Arterial Hypertension

Abstract

Telemedicine allows the remote exchange of medical data between patients and healthcare professionals. It is used to increase patients’ access to care and provide effective healthcare services at a distance. During the recent coronavirus disease 2019 (COVID-19) pandemic, telemedicine has thrived and emerged worldwide as an indispensable resource to improve the management of isolated patients due to lockdown or shielding, including those with hypertension. The best proposed healthcare model for telemedicine in hypertension management should include remote monitoring and transmission of vital signs (notably blood pressure) and medication adherence plus education on lifestyle and risk factors, with video consultation as an option. The use of mixed automated feedback services with supervision of a multidisciplinary clinical team (physician, nurse, or pharmacist) is the ideal approach. The indications include screening for suspected hypertension, management of older adults, medically underserved people, high-risk hypertensive patients, patients with multiple diseases, and those isolated due to pandemics or national emergencies.

Disaster hypertension and cardiovascular events in disaster and COVID‐19 pandemic

“…In cooperation with the practitioners in Minamisanriku Town, where the damage due to the earthquake was serious, we introduced an ICT-based BP monitoring device at evacuation centers and shared patients' BP values in the database to support BP management by remote monitoring ( Figure 5). [22][23][24] Consequently, we succeeded in improving BP control and suppressing seasonal variation in BP (ie, an increase in BP from summer to winter), which has been reported over the years. 23,25 Thus, we believe that ICT might be useful for anticipating needed interventions against BP elevation after a disaster and may contribute to the suppression of disaster-related CVDs.…”

Telemedicine in the management of hypertension: Evolving technological platforms for blood pressure telemonitoring

“…In most, though not, all of the published randomized controlled trials on blood pressure telemonitoring, there were some forms and levels of intervention from the automated electronic system or provided by health professionals for either behavioral or medication management of hypertension (Table 1). 17,18 The intervention varied from one study to another. Nonetheless, the intervention has also to be validated as an essential component of In a recent implementation study in Scottish practices,…”

Connected health: in the right place at the right time

“…Other applications include the early diagnosis of dermatological or pneumological diseases. As shown in Table 2, evidence exists of high effectiveness for managing patients with hypertension [10][11][12][13] , heart failure [12][13][14][15] , acute myocardial infarction and coronary artery disease [16,17] , stroke [18] , chronic kidney disease [19] , diabetes [12,13,15,20] , chronic lung disease [12,13,15] , cancer [15] , and mental illness [21] .…”

“…Diabetes [12,13,15,20] Improved glycemic control in type 2, but not type 1 patients +++ Heart failure [12][13][14][15] Reduced mortality and hospital admissions +++ Chronic lung disease (e.g., asthma and chronic obstructive pulmonary disease) [12,13,15] Improvement in lung function, reduction in the symptoms associated with the illness, and improvement in perceived quality of life ++ Arterial hypertension [10][11][12][13] Improvement in blood pressure control ++ Overweight or obesity [13] Reduction in body weight ++ Stroke [18] Significant improvement in recovery from motor deficits, higher cortical dysfunction, and depression ++ Chronic kidney disease [19] Improvement in the management of dietary sodium intake and fluid management + Acute myocardial infarction [16] Reduced in-hospital mortality +/-Secondary prevention for patients with coronary artery disease [17] Improvement in modifiable cardiovascular risk factors +/-Cancer [15] Improvement in quality of life +/-Mental illness [21] Improvement in adherence to drug treatment + Table 3. Benefits and barriers to implementation of proper e-health and telehealth interventions…”