Changes in quality of life in hypertensive patients during home blood pressure telemonitoring

Abstract

Background The goal of the study was to assess changes in quality of life during the traditional self-measurement of BP at home and combination of the self home BP monitoring with teletransmission occurred in course of antihypertensive treatment.
Material and methods Eighty patients with essential, mild or moderate hypertension never treated (age: 18-65 years). We randomized 40 patients for telemonitoring (TELE), by using the TensioCare^® system and 40 patients for self home BP monitoring group (SDOM), using the OMROM M5-I device. The study lasted 10 months. In both groups the antihypertensive treatment was the same and was intensified during follow-up visits, if BP values were > 130/ 85 mm Hg. Treatment was initiated 1 month after randomization and lasted 9 months. At baseline and after 9 months of pharmacotherapy an assessment of quality of life by standardized questionnaire - the Psychological General Well-being index (PGWB) - 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 treatment a gradual decrease in BP was observed in both groups: in the office (p < 0.01), at home (p < 0.05) and in ABPM (p < 0.05). The ANOVA analysis did not show any BP differences between groups during consecutive followup visits. At baseline total index of the PGWB was the same in both groups (TELE: 91.9 ± 12.7 points v. SDOM: 85.6 ± 17.4 points, p > 0.05). After the treatment period, at 9 month, no differences in quality of life between two groups were found (TELE: 95.6 ± 13.7 points v. SDOM: 90.7 ± 14.5 points, p > 0.05). However in all patients analyzed together (80 subjects), despite of the method of home BP monitoring, a significant improvement in quality of life score was observed, from 88.8 ± 15.5 points at baseline to 93.1 ± 14.2 points at 9 month, respectively (p < 0.01). Analysis of regression showed that only 2 factors were significantly associated with improvement of HRQoL at the end of observation, i.e. lower SBP and DBP values (p < 0.05).
Conclusions Method of home BP monitoring does not influence the quality of life of patients undergoing pharmacotherapy due to hypertension. The improvement in quality of life observed in all patients was an effect of better BP control obtained during treatment.
Arterial Hypertension 2010, vol. 14, no 2, pages 120-127.