Chicago, IL—Patients with uncontrolled hypertension who reported blood pressure (BP) readings to their physicians through a web-based portal received more frequent medication adjustments and more timely treatment decisions compared with a group of patients with hypertension who had only conventional routine office visits, according to a study presented at the 2012 American College of Cardiology meeting.
According to the researchers, “Blood pressure control plays an integral role in the prevention of cardiovascular disease. Aside from lifestyle changes, pharmacotherapy is the physician’s most effective method of lowering blood pressure.”
According to the Centers for Disease Control and Prevention, as many as 65 million American adults have elevated BP, and roughly 74% take medication for it.
In a secondary analysis of this study, patients (average age, 59 ± 13 years) with uncontrolled hypertension (≥150/90 mm Hg) from 2 large medical centers were randomized to usual care (N = 121) or telemedicine with usual care (N = 120). More than half of the patients (56.8%) were taking 1 or 2 BP-lowering medications at the start of the study. Most patients were women; 80% of participants were black.
Patients in the telemedicine group were provided digital sphygmomanometers and were trained on how to use them. They were instructed to report their BP, heart rate, weight, daily steps, and tobacco use twice weekly for 6 months.
All patients had baseline and 6- month follow-up visits. Monthly reports on BP and treatment guidelines were provided to both the patient and the physician in the telemedicine group. At the end of the study, the patients’ antihypertensive medications were compared with their baseline therapy.
At 6 months, the medications prescribed to those in the usual-care group were virtually unchanged, but there was a small increase in the number of medications ordered for patients in the telemedicine group. There were no differences in results with respect to age, ethnicity, education, or income.
Val Rakita, MD, Internal Medicine Resident at Temple University Hospital, Philadelphia, PA, and the study’s coinvestigator, said that prescribing more medication in the telemedicine group did not signify overtreatment but was a reflection of more timely decisions to increase and/or adjust medications.
There was no significant difference in the decrease in BP between the groups overall, but the group of nondiabetic patients using telemedicine was found to have lower BP compared with all of the other groups.
According to Dr Rakita, the findings suggest that an Internet-based intervention results in more appropriate and effective drug therapy for patients with uncontrolled hyper tension, as well as better BP control and an overall reduction in cardiovascular risk.
“The ongoing monitoring and reporting of blood pressure levels seems to bring about important changes in physician prescribing habits, which we think will ultimately benefit patients,” Dr Rakita pointed out.—WK