Abstract P004: Telemonitoring of Blood Pressure in Low-Income African American Patients With Congestive Heart Failure

Abstract

Introduction: Uncontrolled blood pressure (BP) due to non-adherence to medical therapy or inadequate medical therapy in African American (AA) patients with congestive heart failure (CHF) increases the risk of CHF exacerbation. Use of telemonitoring (TM) to monitor BP in low-income AA patients with CHF has not been studied. Aim: To identify patients with uncontrolled BP in low-income AA patients with CHF using a TM device. Methods: We conducted a prospective study of 15 patients with CHF (Ejection Fraction <45%) randomly selected from a Cleveland Clinic outpatient clinic serving a low income AA population. Patients were trained to use a tablet monitor & a BP machine at their home to record their BP everyday for a period of 28 days. Using a secure internet connection patients BP measurement was transmitted to a password protected website where it was studied daily by a nurse to identify abnormal parameters (BP equal to or greater than 140/90 mm of Hg). The nurse contacted patients with abnormal BP measurements to ensure medication adherence. Results: 15 patients consented to participate in the study. During the study period 67% (10/15) patients used the TM device to record BP for more than 50% (14/28 days) of the days. Of these, 50% (5/10) patients had either systolic or diastolic blood pressure equal to or greater than 140/90 mm of Hg for more than 50% of the times they were monitored (Figure 1). Conclusions: Use of TM can help identify patients with CHF whose blood pressure is not at goal and may increase patient’s medication adherence. Whether TM is a cost effective tool to improve clinical outcomes in low income AA patients with CHF & uncontrolled BP needs to be proven in larger studies.