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Digital Management of Hypertension Improves Systolic Blood Pressure Variability
Richard V Milani1, Jonathan K Wilt2, Alexander R Milani3
1Center for Healthcare Innovation, Ochsner Health System, New Orleans, La; Department of Cardiovascular Diseases, John Ochsner Heart and Vascular Institute, Ochsner Clinical School, University of Queensland School of Medicine, New Orleans, La.
The American Journal of Medicine
|December 25, 2019
Summary
Higher systolic blood pressure variability is a key risk factor for cardiovascular events. A digital hypertension program significantly reduced this variability in patients, improving cardiovascular prognosis.
Area of Science:
- Cardiology
- Digital Health
- Hypertension Management
Background:
- Elevated systolic blood pressure variability (SBPV) is a stronger predictor of mortality and cardiovascular events than average blood pressure.
- Long-standing hypertension poses significant risks, necessitating effective management strategies.
Purpose of the Study:
- To assess the impact of a digital hypertension program on systolic blood pressure variability (SBPV).
- To evaluate changes in SBPV in patients with long-standing hypertension managed through a digital health platform.
Main Methods:
- A digital hypertension program was implemented involving 803 patients with long-standing hypertension.
- Home blood pressure readings were transmitted digitally, with virtual medication adjustments and lifestyle coaching.
- Systolic blood pressure variability was measured using the standard deviation of systolic blood pressure values.
Main Results:
- After 24 months, mean SBPV decreased from 12.8 ± 4.3 mm Hg to 9.9 ± 5.1 mm Hg (P <0.0001).
- The proportion of patients in the lowest-risk quartile for SBPV increased from 30% to 57%.
- Digital management improved both average blood pressure and SBPV over time.
Conclusions:
- Patients with hypertension under usual care often have elevated SBPV, increasing cardiovascular risk.
- Digital hypertension management, including remote monitoring and virtual coaching, effectively reduces SBPV.
- Improvements in SBPV achieved through digital health interventions are expected to enhance cardiovascular prognosis.
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