People with high blood pressure who used an at-home monitor
and had regular phone calls with their pharmacist kept their numbers in check
better than those receiving standard care, in a new study. One in three US adults
has high blood pressure, according to the National Institutes of Health.
Only about half have successfully used medication
and lifestyle changes to get their numbers into the recommended range to
prevent heart problems – less than 140/90 or less than 130/80 for those with
diabetes or kidney disease.
So researchers have been looking for new and inexpensive
ways to encourage people with hypertension to stick to their medication
"You don't have to come into
the office to have your blood pressure managed," said Dr Katrin Uhlig from
Tufts Medical Center in Boston, who has studied home blood pressure monitoring.
"I don't think it's the fix for everything, but it certainly is very
promising," Uhlig, who was not involved in the new research, told Reuters
In another recent study, people who were able to communicate
with their pharmacists online ended up with better blood pressure control a
year later. For their report, Dr
Karen Margolis from HealthPartners Institute for Education and Research in
Minneapolis and her colleagues tested an intervention that involved regular
phone meetings with a pharmacist and home blood pressure monitors that
transmitted readings to the pharmacist.
The researchers randomly assigned 228 people with
uncontrolled high blood pressure to go through the so-called telemonitoring
programme for a year and 222 others to stick to their usual primary care
treatment. At both the six-month and one-year check-in, people in the
intervention group had lower systolic and diastolic blood pressure readings.
At the end of the programme, 71% of them had their blood
pressure in the recommended range, compared to 53% of the usual care group.
Those benefits remained after the pharmacist calls ceased, Margolis and her
colleagues reported Tuesday in the Journal of the American Medical Association.
Six months after the intervention ended, 72% of
telemonitoring patients still had their blood pressure under control, versus
57% of people in the comparison group. Participants who received telemonitoring
were prescribed more hypertension drugs during the study.
They also reported feeling more confident about being able
to take care of themselves and made changes such as adding less salt to their
food. "It's kind of creating a feedback loop where patients are measuring
their blood pressure and forwarding that information to the healthcare team,
and the healthcare team is able to interpret that information and feedback
information to the patient... about how they can achieve better blood pressure
control," Margolis told Reuters Health.
The remaining questions, Uhlig said, are if blood pressure
reductions will be maintained years down the line, and if people who had the
intervention will go on to develop fewer heart conditions. The intervention
would cost about R13 500 per patient to implement outside of a study, the
Margolis said they are planning to continue to follow the
patients in this study and perform a more formal cost effectiveness analysis
after a few years. For now, she said patients can buy their own blood pressure
monitor for R300 to R400 and use free online programs, such as one from
the American Heart Association, to record their readings.