Efficacy of home blood pressure telemonitoring in treatment of patients with essential hypertension

Abstract

Background Blood pressure (BP) telemonitoring is a new diagnostic method, based on self home blood pressure measurements, which eliminates an observer error and can improve compliance. The aim of the study was to assess the long-term efficacy of the traditional self-measurement of BP at home and combination of self home BP monitoring with teletransmission during antihypertensive treatment.
Material and methods We recruited 80 patients with primary, mild or moderate hypertension (age: 18-65 yrs.), not yet treated due to hypertension. After randomization the group was divided into: 40 patients for telemonitoring (TELE), by using TensioCare^® system and 40 patients for self home BP monitoring group (SDOM), using OMROM M5-I device. In both groups the antihypertensive treatment was the same and was modified during follow-up visits: after 1, 4, and 7 months of treatment, if needed, i.e. if home blood pressure values were above the goal of treatment (> 130/85 mm Hg). At baseline and at each control visit the ambulatory blood pressure monitoring (ABPM) was performed.
Results At baseline, the TELE and the SDOM groups did not differ in relation to age, gender, BMI, prevalence of diabetes, dyslipidemia, smoking, family history of hypertension and cholesterol, as well as to office BP and ABPM values. During the treatment a gradual decrease in BP was observed in both groups: in the office (TELE: -22.3/- 11.9 mm Hg, SDOM: -24.5/-13.0 mm Hg, p < 0.01), at home (TELE: -8.5/-4.6 mm Hg, SDOM: -8.6/-3.2 mm Hg, p < 0.05) and in ABPM (TELE: -15.0/-8.5 mm Hg, SDOM: -14.0/-6.6 mm Hg, p < 0.05). The ANOVA analysis did not show any BP differences between groups during consecutive follow-up visits. At final assessment during pharmacotherapy, home diastolic BP values in TELE group were significant by lower than in SDOM one.
Conclusions During pharmacotherapy, home BP telemonitoring via the TensioCare^® system - without intermediate staff intervention - provides similar effect on overall BP reduction to self home BP monitoring, when using the OMRON M5-I device.
Arterial Hypertension 2010, vol. 14, no 2, pages 109-119.