Abstract P302: Efficacy Of A Digital Hypertension Self-management And Lifestyle Coaching Program In Reducing Blood Pressure Across Sex, Language And Racial Groups

Abstract

Introduction: Hypertension affects nearly half of adults in the U.S. and is more prevalent in non-Hispanic black and Hispanic people than other groups. HEDIS now includes blood pressure readings from remote monitoring devices that are digitally stored and transmitted to the provider. Digital interventions used to support self-management of hypertension are effective in reducing blood pressure. Healthcare policies that support adoption of innovative digital interventions can positively impact groups with greater health disparities. Hypothesis: We tested the hypothesis that systolic blood pressure (SBP) change observed after 6 months in a smartphone-based hypertension self-management program would demonstrate similar outcomes across subgroups and not be impacted by known health inequities based on sex, language or race. Methods: A cohort study of individuals who enrolled in a digital-only hypertension self-management program without live coaching was used to evaluate SBP change at 6 months and its association with age, sex, language (English/Spanish), and race. Because race information was only available in a subset of the cohort who shared electronic medical records, the largest sub-groups (432 white and 127 non-Hispanic black adults) were compared. Results: 15,361 (age 57 ± .8y, 37% female) people uploaded SBP data at both time points. A reduction in SBP was observed (t = 15.1, p<.01), and the majority (62.3%) reduced SBP. 83.6% (4139 of 4947) of those with stage 2 hypertension (SBP ≥ 140 mm Hg) at program start reduced SBP, with an average reduction of 16.6 ± 0.18 mm Hg. No difference in SBP change was found based on age, race, or preferred language (all ps > .05). Females had a greater reduction in SBP than males (1.5 ± 0.19 mm Hg, p<.01). Conclusions: This study supports the use of a smartphone-based hypertension program incorporating AI driven, digital-only self-management and lifestyle coaching to reduce SBP similarly across age, race, and preferred language groups. Results indicate that digital self-management tools have the potential to bridge health inequity gaps. Future studies could assess whether digital behavioral change coaching leads to reduced SBP across disadvantaged groups based on Area of Deprivation Index (ADI).