Abstract 118: Home Blood Pressure Monitoring Program improves Management of Hypertension

Abstract

Objectives: Regular self-monitoring of blood pressure is an important aspect of the management of hypertension; it enables the hypertensive patient makes better lifestyle choices informed by the measurements obtained from their blood pressure devices. The BP monitoring program by the Center for Connected Health is aimed at empowering patients to better self-manage their health and facilitating improved communication between patients and providers. This study aimed to evaluate the effectiveness of the blood pressure connect program on lowering blood pressures of participants in the program. Methods: The Blood Pressure Connect is a home monitoring program enabling patients to easily collect their blood pressure readings, monitor trends and also share their readings with their providers. Patients measure their blood pressures and upload to a secure web-based platform via modem connection with a home telephone line. Of the 277 hypertensive patients from several Partners affiliated centers enrolled in the program between 7/10/2009 and 11/18/2011, 219 patients aged 22-90 years (59±13 years) were included in the analysis; and 58 (21%) patients were excluded from analysis because they either have only one blood pressure reading or did not upload their blood measurements at all. Paired t-test was used to assess mean change in systolic blood pressure (SBP). Results: Average interval between baseline and final blood pressure measurements was 154 days. According to the JNC-7 classification of blood pressures, 11% had normal SBP, 48% were pre-hypertensive, 30% had stage 1 hypertension and 11% had stage 2 hypertension. Overall, SBP decreased by 6mmHg (95% CI= 4 -8mmHg, p-value <0.0001). SBP decreased by 1mmHg (95% CI=-2 -3mmHg p-value = 0.51), 12mmHg (95% CI= 8 -15mmHg, p-value < 0.0001) and 25mmHg (95% CI=18 - 32mmHg p-value <0.0001) in pre-hypertensive, stage 1 and stage 2 hypertension respectively but increased by -7mmHg (95% CI= -13 - 1mmHg) in those with normal blood pressure. Conclusion: The results show that the program is extremely successful in helping lower the blood pressures of patients with hypertension. These patients belong to a variety of practices, are on different medications and for disparate lengths of time. Despite these differences, all active patients had very similar changes in blood pressure, varying only by their starting blood pressure. Those with established hypertension (stage 1 or 2) saw the most significant change, indicating where the maximum rewards of this program lie. These results reflect the applicability of remote monitoring tools in managing chronic conditions effectively and efficaciously.