Abstract
Background: Home blood pressure telemonitoring (HTM) is recommended by several guidelines in the management of hypertension with its benefits widely documented. HTM enables patients’ active participation in their management and also assists in the diagnoses of white coat and masked hypertension. The feasibility of HTM in poor resource settings such as in Nigeria is unknown. Aim: To determine the feasibility of HTM in Nigeria Methods: We evaluated HTM among Nigerians recruited under the framework of Urinary Proteomics combined with Home Blood Pressure Telemonitoring for Health Care Reforms trial (UPRIGHT-HTM), a multi-centre global clinical trial involving three centres in Nigeria. Eligible patients, aged 55-75 years old with ≥5 cardiovascular diseases risk factors but asymptomatic were trained to collect HTM data using Bluetooth-enabled automated blood pressure (BP) monitors aided with web-based applications that run on android smartphones. Results: Of the 171 patients screened over a 17-month period (May 2021 to September 2022), 1 (0.6%) withdrew consent, 8 (4.8%) without android smart phones, 3 (1.8%) inconsistent with BP measurement over a 5-week run-in period, and 23 (11.3%) who did not meet the inclusion criteria were excluded from this analysis. Of the 136 subjects randomised, 75 (54.4%) were women, 68 (50.0) were obese and 66 (48.5%) had uncontrolled office BP. The time taken to train subjects on HTM averaged at 8.1±3.4 minutes. So far, 44, 236 BP measurements were taken. Overall, the median annual number of BP measurements in the first and second year were 36 and 127 respectively, with monthly median measurements ranging from 12 in August of the first year to 49 measurements in November of the same year. More than 50% of the subjects measured their BP at least 2 times weekly in all but the first quarter of the first year. The average monthly systolic and diastolic BP in each of the 18 months were less than 135mmHg and 85 mmHg respectively. Conclusion: HTM is feasible in clinical trial settings and thus can be integrated into the routine clinical practice in Nigeria.
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