Telecardiology Management of Hypertension in Brazilian Remote Populations

Abstract

Background: Hypertension is highly prevalent worldwide, burdening health systems with inadequate control. Managing hypertension in remote areas of developing countries presents significant challenges. Telemedicine can enhance access to cardiologists and improve treatment adherence. Objective: To assess the effectiveness of telecardiology in managing hypertension in these regions, which remains inadequately understood. Methods: This retrospective cross-sectional study analyzed telecardiology consultations from a single center serving 365 primary health care facilities in North and Midwest Brazil. Patients over 18 years old who were referred to telecardiology and had a primary diagnosis of hypertension. Cardiologists, primary care physicians, and patients participated in real-time outpatient consultations, and data on demographics, blood pressure (BP) levels, diagnostic tests, medication adjustments, and follow-up outcomes were collected. Results: Among 6,141 telemedicine encounters, 4,706 (76.63%) were first visits, and 1,435 (23.37%) were follow-ups. The mean age was 60.31 ± 13.81 years, and 3,657 (59.5) were female. Cardiovascular risk factors were common, including diabetes (24.5%), obesity (24.2%), and smoking (39.4%). Most were handled with basic testing, and only 2.39% had interventions proposed for the possibility of secondary hypertension. Medication adjustments took place in 43.9% of consultations. BP improved significantly in follow-ups (p < 0.05). Most patients (81.97%) needed at least one telemedicine follow-up. Only 0.56% were referred to tertiary care. Conclusion: Telecardiology optimizes hypertension management by enhancing BP control, diagnostic workups, and therapeutic adjustments while decreasing referrals to tertiary care. These findings underscore its potential to reduce health care disparities in underserved areas. Further research is necessary to assess long-term clinical outcomes and scalability.

Keywords: health care disparities; hypertension; remote population; telecardiology; telemedicine.