Physician-led telemedical care enhances blood pressure control in hypertension: a randomized-controlled pilot study...

Despite advances in antihypertensive therapy, blood pressure (BP) control remains inadequate in many patients due to limited follow-up and insufficient medication titration.

This single-centre, randomized controlled pilot trial was conducted at a tertiary academic hospital in Germany between December 2023 to September 2024. Sixty adults with uncontrolled hypertension (office BP >140/90 mmHg despite antihypertensive medication) were randomized 1:1 to standard care or physician-led telemedical care. All participants performed home BP measurements twice daily using validated telemedical devices. The intervention group received structured biweekly calls for BP review and medication optimization. The control group continued care with their general practitioners. The primary endpoint was time in target range (TTR) over 6 months, defined as the percentage of home BP readings below guideline thresholds (<130/80 mmHg for age <65, <140/90 mmHg for age ≥65). Group comparisons used t-tests. The study was registered at CinlicalTrials.gov Identifier [NCT07049289]. Fifty-six patients completed 6-month follow-up (mean age 61 ± 13 years, 61% male). Baseline BP was 161 ± 17/97 ± 12 mmHg. At 6 months, systolic BP decreased by -15.0 ± 9.8 mmHg in the intervention group vs. -4.0 ± 8.7 mmHg in the control group (P < 0.001). Mean systolic TTR was significantly higher in the telemedical care group (52.2 ± 24.2% vs. 36.0 ± 29.2%, P = 0.028), as was diastolic TTR (59.0 ± 31.0% vs. 37.1 ± 34.4%, P = 0.016), and total TTR (42.9 ± 27.5% vs. 24.8 ± 29.7%, P = 0.021). Measurement adherence was superior in the intervention group (83.2 ± 15.4% vs. 70.5 ± 25.9%, P = 0.033).

Physician-supported telemedical care significantly improved BP control and measurement adherence over 6 months. Larger trials are needed to assess long-term clinical outcomes.