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. 2025 Apr;82(4):733-742.
doi: 10.1161/HYPERTENSIONAHA.124.24475. Epub 2025 Jan 31.

The Long-Term Blood Pressure Trends Following a Remote Hypertension Intervention: A Secondary Analysis of the Digital Care Transformation - Remotely Delivered Hypertension Management Program

Shahzad Hassan  1   2 , Alexander J Blood  1   2   3 , David Zelle  1 , Sanjay Kumar  1 , Kavishwar Wagholikar  1 , Daniel Gabovitch  1 , Christopher P Cannon  1   2   3 , Naomi Fisher  4   3 , Benjamin M Scirica  1   2   3
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The Long-Term Blood Pressure Trends Following a Remote Hypertension Intervention: A Secondary Analysis of the Digital Care Transformation - Remotely Delivered Hypertension Management Program

Shahzad Hassan et al. Hypertension. 2025 Apr.

Abstract

Background: Hypertension is a major cardiovascular risk factor, yet traditional care often results in suboptimal blood pressure (BP) control at the population level. We implemented a remote hypertension management program that monitored home BP and titrated medications per algorithm. This study assessed the program's long-term effects by examining participants' office BP up to 42 months post-enrollment.

Methods: Participants of the remote hypertension program were categorized into 4 groups: (1) enrolled-maintenance (achieved goal home BP of ≤130/80 mm Hg), (2) enrolled-early exit (left before achieving goal BP), (3) education-only (lifestyle modifications and medications compliance), and (4) white coat hypertension group (high office BP but normal home BP). Office BP readings of participants were collected up to 42 months post-enrollment. A linear mixed-effects regression model estimated mean BP levels and studied factors associated with above-goal systolic BP in the maintenance group.

Results: Office BP readings from 3601 participants (mean age, 61±11 years; 57% female; 60% white; 52% atherosclerotic cardiovascular disease) were extracted from electronic health records and analyzed. All groups sustained office BP below their qualifying values (P<0.001) over 42 months. In the maintenance group, 89.7% of participants maintained systolic BP at goal, compared with 63.5% in the early exit group, 69.4% in the education-only group, and 90.7% in the white coat hypertension group. Age >50 years was associated with above-goal systolic BP in the maintenance group.

Conclusions: Participants who achieved BP control through the remote hypertension program maintained goal systolic BP in 90% of cases up to 42 months post-enrollment. These findings highlight the long-term benefits of remote, intensive management programs for effective hypertension control.

Keywords: blood pressure; cardiovascular diseases; electronic health records; hypertension; risk factors.

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Conflict of interest statement

S. Hassan is supported by the National Institutes of Health grant T32HL007604. A.J. Blood reports research grants from Boehringer Ingelheim (BI), Novo Nordisk, Eli Lilly, and General Electric Health; consulting fees from Color Health, Medscape, Milestone Pharmaceuticals, Novo Nordisk, Arsenal Capital Partners, and Walgreens Health; and equity from Knownwell and Porter Health. S. Kumar, D. Zelle, and D. Gabovitch report research grants and related funding via Brigham and Women’s Hospital: BI, Eli Lilly, Milestone Pharmaceuticals, and Novo Nordisk. K. Wagholikar reports research grants and related funding from the National Heart, Lung, and Blood Institute (R01HL151643). C.P. Cannon reports research grants from Amgen, Better Therapeutics, BI, and Novo Nordisk and salary support from Colorado Prevention Center Clinical Research, which gets research grant support from Amgen, Bayer, Cleerly, Esperion, Lexicon, and Silence; consulting fees from Amryt/Chiesi, Amgen, Ascendia, Biogen, VI, Bristol Myers Squibb, CSL Behring, Genomadix, Lilly, Janssen, Lexicon, Milestone, Pfizer, and Rhoshan; and serves on Data and Safety Monitoring Boards for the Areteia, Novo Nordisk, ROMTherapy Inc, and the Veterans Administration. N. Fisher reports research grants from Amgen, Better Therapeutics, BI, Daiichi Sankyo, Merck, Novo Nordisk, and Pfizer; consulting fees from Amryt/Chiesi, Alnylam, Amarin, Amgen, Applied Therapeutics, Ascendia, Biogen, BI, Bristol Myers Squibb, CSL Behring, Eli Lilly, Janssen, Lexicon, Merck, Milestone, Pfizer, Rhoshan, and Sanofi. B.M. Scirica reports research grants via Brigham and Women’s Hospital from Better Therapeutics, BI, Merck, Novo Nordisk, and Pfizer; consulting fees from Abbvie (Data Safety Monitoring Board [DSMB]), AstraZeneca (DSMB), BI, Better Therapeutics, Bristol Myers Squibb, Elsevier Practice Update Cardiology, Esperion, Hanmi (DSMB), Lexeo (DSMB), Lexicon, Novo Nordisk; and equity from Health [at] Scale.

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