O26 SUSTAINED BLOOD PRESSURE CONTROL FOLLOWING A HOME BLOOD PRESSURE TELEMONITORING PROGRAM

Abstract

Background and Objective: Home blood pressure telemonitoring (HBPT) facilitates HBP monitoring and reduces office BP. Evidence whether BP control can be sustained via HBPT is lacking. We examined the effects of a HBPT program on sustained BP control. Methods: We included patients enrolled in a HBPT program at a large integrated US healthcare system from November 2019-June 2022. Patients with uncontrolled hypertension were enrolled by a clinician, given a BP device and provided consent through an app. Patients were asked to measure their BP three mornings and three evenings each week before taking antihypertensive medication. BP readings were synced to the app, and non-physician providers titrated medications. Patients were successfully discharged from the program after achieving control (at least two 1-week average BPs and last BP in one month <135/85 mmHg). We examined mean clinic BP reduction before and after enrollment to HBPT and sustained BP control (last clinic BP <140/90 mmHg in the 12 months following discharge). Multivariable robust Poisson regression was used to identify factors associated with sustained BP control at 12 months. Results: A total of 3574 patients were enrolled and 2123 (59%) consented; of these, 63 (3%) did not submit >1 BP, 780 (37%) were actively enrolled, 644 (30%) disenrolled without meeting BP control and 636 (30%) achieved control and were discharged after a mean of 4 months. Among the 636 successfully discharged, 527 (83%) had clinic BP during follow-up. Compared with the last clinic BP prior to HBPT enrollment, mean (SD) clinic SBP and DBP was reduced by 16.3 (22.6) mmHg and 10.0 (12.3) mmHg, respectively (p<.0001 for both) and 75% of patients sustained BP control at 12 months. Younger patients and patients with high SBP prior to HBPT were less likely to sustain BP control at 12 months (Figure). Conclusions: While the HBPT program in this healthcare system shows promise for sustained BP control, strategies to enroll/consent patients and spread the program are warranted.