Effectiveness of the intelligent hypertension excellence centers (iHEC) therapy model in the blood pressure management of older hypertensive patients: a randomized controlled trial

Abstract

Intelligent hypertension excellence centers (iHEC) may improve blood pressure (BP) management in older hypertensive patients. However, this has not yet been rigorously evaluated, so we conducted a prospective randomized open-label clinical trial to verify this hypothesis. Older patients with hypertension were recruited between January and June 2022. The control group received conventional treatment and visited doctors in clinic. The intervention group received the iHEC therapy model, including remote BP management, online consultation, and follow-up services with support from the internet. Both groups received 12 months follow-up. Finally, 540 older patients with hypertension participated in the study; of these, 517 completed the follow-up. The average age was 71.4 ± 3.7years, 81 patients with frailty (15.7%). When follow-up was terminated, the SBP of the intervention group was 4.2 mmHg lower than that of the control group (95% CI, 2.0 to 6.4, P < 0.001), and the overall BP control rate in the intervention group was higher than that in the control group (60.2% vs. 48.1%, P < 0.05). During follow-up, the new-onset rate of excessive BP lowering in the intervention group was lower than that in the control group (3.8% vs. 9.0%, P < 0.05). Patients with a median age or above and high school education or above had higher numbers of online consultations and home BP measurements (P < 0.05).Our study confirmed those who received the iHEC therapy model achieved better BP reduction, higher rates of BP control, and alleviated the risk of excessive BP reduction.

Keywords: blood pressure management; hypertension; intelligent; older.

Fig. 1

The process of the iHEC Therapy Model

Fig. 2

Flowchart of iHEC therapy model (Recruitment, Randomization, and Participant)