open access

Vol 11, No 4 (2007)
Prace oryginalne
Published online: 2007-09-07
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Effect of telemonitoring of blood pressure in patients with hypertension

Marek Rajzer, Małgorzata Brzozowska-Kiszka, Grzegorz Bilo, Wiktoria Wojciechowska, Kalina Kawecka-Jaszcz
Nadciśnienie tętnicze 2007;11(4):318-327.

open access

Vol 11, No 4 (2007)
Prace oryginalne
Published online: 2007-09-07

Abstract

Background Telemonitoring of blood pressure is a new diagnostic technique which provides information about blood pressure at home, eliminating observer error and sending results to doctor. The aim of the study was a comparison between self blood pressure measurement and telemonitoring systems in blood pressure treatment monitoring, accuracy and variability.
Material and methods We randomized 70 patients with primary mild or moderate hypertension (mean age - 50.4 year, SD - 9.9) non-treated into two groups: 35 to telemonitoring group (TELE) and 35 to self home blood pressure measurement group (SDOM). Antihypertensive treatment regime in both groups was the same. In SDOM group blood pressure measurements were performed with OMRON M5-I device (two measurements morning and two in the evening hours) reported in two week intervals. In TELE group we applied telemonitoring system of blood pressure (TensioCare) were sending data to central server in doctor office in two week intervals. On the basis of blood pressure measurements result we modify drug doses. During first visit and after 1 month of treatment we performed 24-hour ambulatory blood pressure monitoring (ABPM). At the first visit global risk in EuroSCORE was calculated for each patient. Echocardiography was performed using VIVID 7 GE device.
Results 1. Diastolic blood pressure after 4 weeks of treatment in TELE group was significantly lower than in SDOM group:- for whole day: 78.1 (SD - 9.1) mm Hg vs. 84.4 (SD - 9.4) mm Hg; p = 0.005; - in morning hours: 77.4 (SD - 8.8) mm Hg vs. 85.0 (SD - 10.0) mm Hg; p = 0.001; - in evening hours: 78.5 (SD - 9.5) mm Hg vs. 83.3 (SD - 8.8) mm Hg; p = 0.03. 2. Variability of diastolic blood pressure was lower in TELE group in comparison to SDOM group: 7.2 (SD - 1.8) mm Hg vs. 9.5 (SD - 3.9) mm Hg; p = 0.002. 3. Diastolic blood pressure in TELE group was significantly correlated with global cardio-vascular risk in EuroSCORE scale: r = 0.12; p < 0.05, and systolic blood pressure in Tele group was correlated with left ventricular hypertrophy: r = 0.21; p < 0.05. We didn’t observe that correlation for blood pressure measurements in SDOM group.
Conclusions Telemonitoring system is more sensitive method than home blood pressure self measurement to detect early changes of blood pressure during treatment. Blood pressure values from telemonitoring system are less variable and in closer relationships with global cardio-vascular risk in EuroSCORE scale and left ventricular hypertrophy. Arterial Hypertension 2007, vol. 11, no 4, pages 318-327.

Abstract

Background Telemonitoring of blood pressure is a new diagnostic technique which provides information about blood pressure at home, eliminating observer error and sending results to doctor. The aim of the study was a comparison between self blood pressure measurement and telemonitoring systems in blood pressure treatment monitoring, accuracy and variability.
Material and methods We randomized 70 patients with primary mild or moderate hypertension (mean age - 50.4 year, SD - 9.9) non-treated into two groups: 35 to telemonitoring group (TELE) and 35 to self home blood pressure measurement group (SDOM). Antihypertensive treatment regime in both groups was the same. In SDOM group blood pressure measurements were performed with OMRON M5-I device (two measurements morning and two in the evening hours) reported in two week intervals. In TELE group we applied telemonitoring system of blood pressure (TensioCare) were sending data to central server in doctor office in two week intervals. On the basis of blood pressure measurements result we modify drug doses. During first visit and after 1 month of treatment we performed 24-hour ambulatory blood pressure monitoring (ABPM). At the first visit global risk in EuroSCORE was calculated for each patient. Echocardiography was performed using VIVID 7 GE device.
Results 1. Diastolic blood pressure after 4 weeks of treatment in TELE group was significantly lower than in SDOM group:- for whole day: 78.1 (SD - 9.1) mm Hg vs. 84.4 (SD - 9.4) mm Hg; p = 0.005; - in morning hours: 77.4 (SD - 8.8) mm Hg vs. 85.0 (SD - 10.0) mm Hg; p = 0.001; - in evening hours: 78.5 (SD - 9.5) mm Hg vs. 83.3 (SD - 8.8) mm Hg; p = 0.03. 2. Variability of diastolic blood pressure was lower in TELE group in comparison to SDOM group: 7.2 (SD - 1.8) mm Hg vs. 9.5 (SD - 3.9) mm Hg; p = 0.002. 3. Diastolic blood pressure in TELE group was significantly correlated with global cardio-vascular risk in EuroSCORE scale: r = 0.12; p < 0.05, and systolic blood pressure in Tele group was correlated with left ventricular hypertrophy: r = 0.21; p < 0.05. We didn’t observe that correlation for blood pressure measurements in SDOM group.
Conclusions Telemonitoring system is more sensitive method than home blood pressure self measurement to detect early changes of blood pressure during treatment. Blood pressure values from telemonitoring system are less variable and in closer relationships with global cardio-vascular risk in EuroSCORE scale and left ventricular hypertrophy. Arterial Hypertension 2007, vol. 11, no 4, pages 318-327.
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Keywords

hypertension; telemonitoring; ABPM; self blood pressure measurement; EuroSCORE scale

About this article
Title

Effect of telemonitoring of blood pressure in patients with hypertension

Journal

Arterial Hypertension

Issue

Vol 11, No 4 (2007)

Pages

318-327

Published online

2007-09-07

Bibliographic record

Nadciśnienie tętnicze 2007;11(4):318-327.

Keywords

hypertension
telemonitoring
ABPM
self blood pressure measurement
EuroSCORE scale

Authors

Marek Rajzer
Małgorzata Brzozowska-Kiszka
Grzegorz Bilo
Wiktoria Wojciechowska
Kalina Kawecka-Jaszcz

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