Short-term telemedical home blood pressure monitoring does not improve blood pressure in uncomplicated hypertensive patients

Abstract

Telemonitoring of home blood pressure measurements (TBPM) is a new and promising supplement to diagnosis, control and treatment of hypertension. We wanted to compare the outcome of antihypertensive treatment based on TBPM and conventional monitoring of blood pressure. Participants were recruited from a prevalence study among citizens aged 55-64 years in the municipality of Holstebro, Denmark. The study was a randomized, controlled, unblinded 3 months' trial. In the intervention group, antihypertensive treatment was based on TBPM with transmission of the measurements and subsequent communication by telephone or e-mail. In the control group, patients received usual care. Primary outcome was reduction in daytime ambulatory blood pressure measurements (ABPM) from baseline to 3 months' follow-up. Of 375 participants randomized, primary outcome data were available for 356 (95%). In both groups, daytime ABPM decreased significantly. The decrease in daytime ABPM in the intervention group was systolic/diastolic, -8±12/-4±7 mm Hg. This did not differ significantly from the control group's -8±13/-4±8 mm Hg. An equal number of participants obtained normal daytime ABPM, in the intervention group 17% (31/175) versus control 21% (37/181), P=0.34. We found that both TBPM patients and controls achieved a significant blood pressure reduction in this randomized, controlled, unblinded 3-month trial. We found no difference in blood pressure reduction or number of patients reaching blood pressure goals. Further information and education of some general practitioners seem to be relevant regarding blood pressure management and control of hypertension.

An Updated Meta-Analysis of Remote Blood Pressure Monitoring in Urban-Dwelling Patients with Hypertension

“…The completion dates were in or prior to the year 2000 for two studies [41,42], between 2001 and 2010 for 14 studies [25,29,[43][44][45][46][47][48][49][50], and between 2011 and 2020 for 32 studies. Seven studies had used mean values for ABPM [47,48,[50][51][52][53][54].…”

“…No outliers were detected in the sensitivity test performed through sequentially omitting each study. When the average effect of RBPM was chronologically divided into three timeframes and compared with the UC group (Phase I, inception of RBPM to 2000; phase II, 2001-2010; phase III, 2011-2020), the WMD was 1.515 mmHg (n = 2, −4.031-7.061, p = 0.592; I 2 = 0.000%, p = 0.478) in phase I [41,42], 4.333 mmHg (n = 14, 2.338-6.328, p < 0.001; I 2 = 38.554, p < 0.001) in phase II [25,29,[43][44][45][46][47][48][49][50], and 4.719 mmHg (n = 32, 3.343-6.094, p < 0.001; I 2 = 77.361%, p < 0.001) in phase III [26][27][28][30][31][32][33][34][35][51][52][53][54][55][56][57][58][59][60][61].…”

“…To determine the effect of RBPM on DBP, data concerning 10,482 patients (UC group, n = 5,192; RBPM group, n = 5,290) were analyzed across 29 studies (44 comparisons) [25,[27][28][29][30][31][32][33][34][35][41][42][43][44][45][46][47][48][49][50][51][52][53][54][56][57][58][59]61]. Compared with the UC group, the RBPM group showed greater BP reduction (SMD, 0.315 mmHg (0.209-0.402), p < 0.001; WMD, 2.075 mmHg (1.399-2.750) p <0.001) after conversion (Figure 6).…”

Changes in Brachial and Central Blood Pressure after Short Term Continuous Positive Airway Pressure Treatment of Patients with Moderate-to-Severe Obstructive Sleep Apnoea and Impaired Renal Function

“…Patients were recruited from the Renal Outpatient Clinic, Holstebro Hospital (eGFR 15 -59 mL/min/1.73 m 2 ) or from a population study in Holstebro County (diagnosis of hypertension and eGFR 60 -89 mL/min/1.73 m 2 ) [20]. All patients were diagnosed with moderate-to-severe OSA and had not received CPAP treatment previously.…”

Home blood pressure telemonitoring for improving blood pressure control in middle‐aged and elderly patients with hypertension

“…However, the findings from previous studies regarding the relationship between HBPT and BP control are still controversial. In some randomized clinical trials, telemonitoring did not have a significant effect on improving BP control or lowering BP 18–20 . In view of the differences in research design, target population, management method, and data analysis of these studies, additional studies are important.…”