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. 2024 Aug 9;12(16):1583.
doi: 10.3390/healthcare12161583.

Remote Patient Monitoring Is Associated with Improved Outcomes in Hypertension: A Large, Retrospective, Cohort Analysis

Wesley Smith  1 , Brett M Colbert  1 , Tariq Namouz  2 , Dean Caven  3 , Joseph A Ewing  2 , Andrew W Albano  2
Affiliations

Remote Patient Monitoring Is Associated with Improved Outcomes in Hypertension: A Large, Retrospective, Cohort Analysis

Wesley Smith et al. Healthcare (Basel). .

Abstract

Hypertension (HTN) is a chronic condition that requires careful monitoring and management. Blood pressure readings in the clinic and self-reported blood pressure readings are often too intermittent to allow for careful management. Remote patient monitoring is a solution that may have positive impacts on HTN management. Individuals at cardiac and primary care clinics were prescribed a remote patient-monitoring (RPM) program. Patients were sent blood pressure monitors that were enabled to transmit data over cellular networks. We reviewed trends in HTN management retrospectively in patients who had previously been on conventional therapy for a year and participated in RPM for a minimum of 90 days. There were 6595 patients enrolled, and the mean duration on RPM was 289 days. A total of 4370 participants (66.3%) had uncontrolled HTN, and 2476 (37.5%) had stage 2 HTN. After at least 90 days on the RPM program, the number of patients with uncontrolled HTN reduced to 2648 (40.2%, p < 0.01), and the number of patients with stage 2 HTN reduced to 1261 (19.1%, p < 0.01). Systolic blood pressure improved by 7.3 mmHg for all patients and 16.7 mmHg for stage 2 HTN. There was improvement in mean arterial pressure (MAP) in all patients with uncontrolled HTN by 8.5 mmHg (p < 0.0001). RPM is associated with improved HTN control and provides further evidence supporting telehealth programs which can aid in chronic disease management.

Keywords: chronic care management; hypertension; remote patient monitoring; telehealth.

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Conflict of interest statement

W.S. is compensated by HealthSnap, Inc. and is a shareholder. B.C. is compensated by HealthSnap, Inc. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
RPM is associated with a reduction in patients with uncontrolled hypertension and stage 2 hypertension. (A) Percentage of patients with uncontrolled hypertension at baseline (SBP > 130 mmHg or DBP > 80 mmHg). (B) Percentage of patients with uncontrolled hypertension after enrollment in the RPM program. (n = 6595, p < 0.01, two-tailed McNemar test; average time on RPM = 289 days) (C) Percentage of patients with stage 2 hypertension (SBP > 140 mmHg or DBP > 90 mmHg) at baseline. (D) Percentage of patients with stage 2 hypertension after enrollment in the RPM program. (n = 6595, p < 0.01, two-tailed McNemar Test; average time on RPM = 289 days).
Figure 2
Figure 2
Improvements in systolic and diastolic blood pressure and pulse pressure associated with rpm. (A) Change in average systolic blood pressure (in mmHg) from baseline to end of analysis period (mean of 289 days) among all patients (−7.3 mmHg), uncontrolled hypertensives (−11.9 mmHg), and stage 2 hypertensives (−16.7 mmHg). (B) Change in average diastolic blood pressure (in mmHg) from baseline to end of analysis period (mean of 289 days) among all patients (−4.4 mmHg), uncontrolled hypertensives (−6.8 mmHg), and stage 2 hypertensives (−9.0 mmHg). (C) Change in average pulse pressure (in mmHg) from baseline to end of analysis period (mean of 289 days) among all patients (−4.4 mmHg), uncontrolled hypertensives (−6.8 mmHg), and stage 2 hypertensives (−9.0 mmHg) (paired t-test, **** p < 0.0001).
Figure 3
Figure 3
Improvements in mean arterial pressure (MAP). (A) Change in average MAP (mmHg) from baseline to end of analysis period among all patients with uncontrolled hypertension (paired t-test). (B) Improvements in MAP in uncontrolled hypertension over time quartiles of time on the RPM program. More time is associated with a greater improvement (Kruskal–Wallis Test; * p < 0.05, *** p < 0.001, **** p < 0.0001).
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