Home Monitoring Service Improves Blood Pressure Control in Patients with High Blood Pressure

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The summary below is from the full report titled "Home Monitoring Service Improves Mean Arterial Pressure in Patients with Essential Hypertension. A Randomized, Controlled Trial." It is in the 5 June 2001 issue of Annals of Internal Medicine (volume 134, pages 1024-1032). The authors are MAM Rogers, D Small, DA Buchan, CA Butch, CM Stewart, BE Krenzer, and HL Husovsky.

What is the problem and what is known about it so far?

High blood pressure (hypertension) is a common medical problem in adults. Treatments to reduce blood pressure include diet, exercise, and medicines. Lowering blood pressure helps to prevent the complications of high blood pressure, which include heart disease, kidney disease, and stroke. Unfortunately, many people with hypertension either go untreated or receive treatments that do not lower blood pressure enough. New ways of transferring information through telephone lines present opportunities for improving the delivery of health care.

Why did the researchers do this particular study?

To find out whether a system that measures patients' blood pressure at home and sends weekly results to the patients and their doctors by telephone can improve blood pressure control.

Who was studied?

The study included 121 adults with uncontrolled high blood pressure who were being considered for a change in blood pressure medicines.

How was the study done?

The researchers randomly assigned patients to receive either usual care from their doctors or a home service that automatically transmitted blood pressure readings to patients and their doctors over telephone lines. Patients assigned to the monitoring service were asked to use a special measuring device to take their blood pressure three times each morning before breakfast and three times each evening before going to bed at least 3 days per week for at least 8 weeks. Readings were transmitted to a central station over telephone lines; doctors and patients received a weekly report that summarized the readings. To determine whether the service was helpful in reducing blood pressure, the researchers measured usual blood pressure in each patient at the beginning and end of the study by using a device that measured pressures many times over a 24-hour period. The home monitoring service cost about $25 per month.

What did the researchers find?

Blood pressure decreased in patients in the home monitoring group while it remained the same or increased in patients getting usual care. The benefits of the monitoring service appeared particularly striking for African-American patients. Part of the decrease in blood pressure was due to more frequent changes in blood pressure medicines for patients in the home monitoring group.

What were the limitations of the study?

The study was relatively small and lasted for a relatively short time, so it is uncertain that the results would be similar in other patients or would hold up over longer periods. Of note, the company that makes the monitoring device paid for the study but did not participate in the conduct or reporting of the study.

What are the implications of the study?

This telecommunication service appeared helpful in reducing the blood pressure of patients with uncontrolled high blood pressure. This may be because the frequent blood pressure measures prompted frequent changes in medicines if blood pressure was not controlled.