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Blood pressure control during telemonitoring of home blood pressure. A randomized controlled trial during 6 months
Line Bille Madsen1, Peder Kirkegaard, Erling Bjerregaard Pedersen
1Department of Medical Research, Holstebro Hospital and Aarhus University, Denmark. limba@ringamt.dk
Aim:
To compare the effectiveness of antihypertensive treatment based on telemonitoring of home blood pressure (BP) and conventional monitoring of office BP.
Methods:
Hypertensive patients (n = 236) participated in a randomized, controlled study. In the intervention group, antihypertensive treatment was based on home BP monitoring. BP readings were registered by a PDA and automatically transmitted to a server, by which the patient and doctor could communicate. In the control group, patients received usual care with office visits to adjust antihypertensive treatment as needed. Primary outcome was difference in systolic daytime ambulatory BP monitoring (ABPM) change between baseline and 6 months.
Results:
In both groups, systolic daytime ABPM decreased significantly from baseline to follow-up. The decrease in systolic daytime ABPM was -11.9 mmHg in the intervention group and -9.6 mmHg in the control group (mean difference -2.3 [95% CI -6.1 to -1.5], p = 0.225). The likelihood of daytime ABPM normalization was similar in the two groups [32/113 (28%) vs 46/123 (37%), p = 0.139].
Conclusion:
Antihypertensive treatment based on telemonitoring of home BP was as effective as usual monitoring of office BP with regards to reduction of BP.
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Pre-Procedural Guidelines for Assessing Blood Pressure
Special considerations while measuring blood pressure
Monitoring Both Arms:
Monitoring BP in both arms during the initial assessment is advisable, as the systolic value may differ by five to ten mm Hg between arms. For subsequent BP assessments, use the arm with the higher reading.
Assessment of blood pressure in brachial artery(two-step method)
Assessment of blood pressure in brachial artery(one-step method)
Prepare for the Procedure:
Assessing Blood pressure in the Leg
Preparation: