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Improving Blood Pressure in High-Risk Patients With CKD Using an Interdisciplinary Remote Hypertension Program
Molly C Fisher1, Sharon Rikin2, Sonali Gupta1
1Division of Nephrology, Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, New York, New York, USA.
Kidney International Reports
|April 30, 2025
Summary
This study shows that remote patient monitoring (RPM) effectively improves blood pressure (BP) control in Black and Hispanic patients with chronic kidney disease (CKD). The program demonstrated high feasibility and significant BP reductions, offering a promising approach to reduce health disparities.
Area of Science:
- Nephrology
- Cardiology
- Health Equity
Background:
- Racial and ethnic disparities persist in achieving blood pressure (BP) control among patients with chronic kidney disease (CKD).
- Interventions are needed to address these disparities and improve hypertension management in vulnerable populations.
- Remote patient monitoring (RPM) offers a potential solution for enhanced BP management in CKD patients.
Purpose of the Study:
- To determine the feasibility and effectiveness of an interdisciplinary RPM hypertension program.
- To evaluate the program's impact on BP control in predominantly Black and Hispanic patients with CKD.
- To assess the potential of RPM in reducing racial and ethnic disparities in hypertension management.
Main Methods:
- An RPM hypertension program was evaluated in a New York City health system (July 2021-October 2022).
- Patients used cellular-enabled BP devices for real-time data transmission, receiving lifestyle education and telemedicine-based medication adjustments by a nurse practitioner.
- Feasibility was assessed by enrollment, participation, and retention rates; BP control was measured by mean BP change at 3 months and the proportion achieving BP < 130/80 mmHg at 6 months.
Main Results:
- The program demonstrated high feasibility, with 91.9% enrollment and 78.4% retention at 3 months among invited patients.
- Significant mean reductions in systolic BP (-15.0 mmHg) and diastolic BP (-6.7 mmHg) were observed at 3 months (P < 0.0001 and P = 0.0007, respectively).
- By 6 months, 49.4% of participants achieved the target BP of < 130/80 mmHg.
Conclusions:
- The interdisciplinary RPM hypertension program was feasible and effective in improving BP control in CKD patients.
- This approach shows promise for increasing equity in hypertension management, particularly for racial and ethnic minority groups.
- Further research is needed to evaluate the long-term maintenance of BP control with RPM compared to usual care.
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