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Review
. 2021 Oct 9;18(20):10583.
doi: 10.3390/ijerph182010583.

An Updated Meta-Analysis of Remote Blood Pressure Monitoring in Urban-Dwelling Patients with Hypertension

Sang-Hyun Park  1 , Jong-Ho Shin  1 , Joowoong Park  2 , Woo-Seok Choi  3   4
Affiliations
Review

An Updated Meta-Analysis of Remote Blood Pressure Monitoring in Urban-Dwelling Patients with Hypertension

Sang-Hyun Park et al. Int J Environ Res Public Health. .

Abstract

Following the coronavirus disease-2019 pandemic, this study aimed to evaluate the overall effects of remote blood pressure monitoring (RBPM) for urban-dwelling patients with hypertension and high accessibility to healthcare and provide updated quantitative summary data. Of 2721 database-searched articles from RBPM's inception to November 2020, 32 high-quality studies (48 comparisons) were selected as primary data for synthesis. A meta-analysis was undertaken using a random effects model. Primary outcomes were changes in office systolic blood pressure (SBP) and diastolic blood pressure (DBP) following RBPM. The secondary outcome was the BP control rate. Compared with a usual care group, there was a decrease in SBP and DBP in the RBPM group (standardized mean difference 0.507 (95% confidence interval [CI] 0.339-0.675, p < 0.001; weighted mean difference [WMD] 4.464 mmHg, p < 0.001) and 0.315 (CI 0.209-0.422, p < 0.001; WMD 2.075 mmHg, p < 0.001), respectively). The RBPM group had a higher BP control rate based on a relative ratio (RR) of 1.226 (1.107-1.358, p < 0.001). RBPM effects increased with increases in city size and frequent monitoring, with decreases in intervention duration, and in cities without medically underserved areas. RBPM is effective in reducing BP and in achieving target BP levels for urban-dwelling patients with hypertension.

Keywords: blood pressure; hypertension; remote monitoring; telemedicine; urban.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure A1
Figure A1
Note: point estimate of individual study (●), summary effect size (◆); SBP, systolic blood pressure; UC, usual care; RBPM, remote blood pressure monitoring.
Figure A2
Figure A2
Note: point estimate of individual study excluding each individual study (●), summary effect size (◆); SBP, systolic blood pressure; SMD, standardized mean difference; UC, usual care; RBPM, remote blood pressure monitoring.
Figure A3
Figure A3
Note: point estimate of individual study (○); RBPM, remote blood pressure monitoring.
Figure 1
Figure 1
PRISMA flow of study. Abbreviations: BP, blood pressure; CVD, cardiovascular disease; CVA, cerebro-vascular accident; DBP, diastolic blood pressure; SBP, systolic blood pressure.
Figure 2
Figure 2
A funnel plot of the standardized mean difference in systolic blood pressure. Note: summary effect size (◇), summary effect size of imputed studies (◆), individual study (○).
Figure 3
Figure 3
A funnel plot of standardized mean difference in diastolic blood pressure. Note: summary effect size (◇), summary effect size of imputed studies (◆), individual study (○).
Figure 4
Figure 4
A funnel plot of relative risk for the target blood pressure rate. Note: summary effect size (◇), imputed study (●), summary effect size of imputed studies (◆), individual study (○).
Figure 5
Figure 5
A forest plot of standardized mean difference in systolic blood pressure. Note: point estimate of individual study (●), summary effect size (◆); SBP, systolic blood pressure; UC, usual care; RBPM, remote blood pressure monitoring.
Figure 6
Figure 6
A forest plot of standardized mean difference in diastolic blood pressure. Note: point estimate of individual study (●), summary effect size (◆); DBP, diastolic blood pressure; UC, usual care; RBPM, remote blood pressure monitoring.
Figure 7
Figure 7
Risk ratio of target blood pressure using remote blood pressure monitoring. Note: point estimate of individual study (●), summary effect size (◆); BP, blood pressure; UC, usual care; RBPM, remote blood pressure monitoring.
See this image and copyright information in PMC

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