NP Telehealth Blood Pressure Management in Heart Transplant Patients - A Single Center Experience

Abstract

<h3>Purpose</h3> Hypertension (HTN) is common in heart transplant (HTx) recipients due to calcineurin inhibitors, steroids and renal disease. HTN increases risk of transplant vasculopathy, left ventricular hypertrophy, and renal failure, emphasizing need for adequate control. We assessed the effectiveness of nurse practitioner (NP) telehealth visits in achieving adequate blood pressure (BP) control in HTx patients (pts). <h3>Methods</h3> A retrospective study included HTx pts scheduled for a video or telephone visit with a HTx NP for BP management between Sept 2020 and July 2021. Pts hypertensive during a clinic visit, and requiring initiation or adjustment of antihypertensives, were referred for a follow up NP telehealth visit. Target BP goal was <130/80. Pts were instructed to obtain sitting BP 1-2 times/day at home, 2 hours after taking BP medications. Data obtained: BP measurements at clinic and with each NP telehealth visit, number of days from intervention to attainment of goal BP, number of NP visits conducted, and number of antihypertensive agents required to reach goal BP. <h3>Results</h3> Of 73 pts, 60 were followed by NP until target BP reached, 13 pts were hospitalized, lost to follow up, transferred care locally, or still undergoing titration of antihypertensives by NP. Of the 60 pts, average number of days to attain goal BP was 40.7 days, 83% of pts required 1-2 NP telehealth visits to attain goal BP, 78% of pts required 1-2 antihypertensive agents to attain goal BP. <h3>Conclusion</h3> NP telehealth BP management was effective in achieving target BP efficiently in HTx pts. Further studies evaluating long term BP control and optimal frequency of visits should be conducted.