Abstract 13930: The Impact of a Remote Patient Monitoring Program on Blood Pressure Control, Glycemic Control, and Lipids in Patients With Hypertension: A 3.5-year Retrospective Analysis Across 39 Physician Practices

Abstract

Introduction ​​Self-measured blood pressure monitoring (SMBP) is recommended for hypertension (HTN) management and remote patient monitoring (RPM) can empower clinicians to manage HTN more efficiently. We examined the impact of a digital health program integrating RPM, SMBP, and nutrition/lifestyle coaching for patients with HTN. Methods 37 primary care practices and 2 cardiology practices across 10 US states enrolled patients with HTN diagnosis (regardless of their baseline BP control status) into the iHealth Unified Care program from 2018 to 2022. Bluetooth connected devices with mobile app or WIFI connected BP monitors, a web-based clinical care platform, and real time data analytics were utilized. Physicians and their care team, including registered dietitians, provided assessment, goal setting, continuous monitoring, and follow up visits if needed. The 7-day average BP value at baseline and the most recent measurement 7-day period were calculated to analyze BP control status. Results 3364 patients (age: 65.7 ± 12.1 years, 48.7% female) with baseline and endpoint BP data were included. Enrollment was continuous with an average duration in the program of 1.5 years. The baseline average BP was 138/81mmHg and the overall SBP/DBP reduction was -5.3 ± 15.1 / -3.1 ± 8.4 mmHg (P<0.0001) at the endpoint. The proportion with HTN controlled to <130/80 mmHg was increased from 21.8% to 36.0% (P<0.0001), and those controlled to <140/90 mmHg increased from 53.9% to 63.7% (P<0.0001). In a subgroup analysis on patients with Stage II HTN at baseline (n=1552), the SBP/DBP reduction was -11.9 ± 15.4 /-6.3 ± 8.7 mmHg (p<0.0001) and more significant BP reductions were observed after 6 weeks, and further improved at 3 months, 6month, and 12months respectfully. Of patients with diabetes, HbA1c was reduced by 0.5 ± 1.4% (n=337, p<0.001) and of those with hyperlipidemia (LDL-C >100mg/dL) at baseline (n=264), LDL-C also was reduced significantly (-19.6 ± 38.4 mg/dL, P<0.001). Conclusions: The digital BP monitoring program significantly improved the BP control in patients with HTN as well as HbA1c and LDL-C in those who also had diabetes and hyperlipidemia, respectively. Long term and randomized control trials are needed to further evaluate the impact on cardiovascular risk.