STRATEGY OF DISTANCE ACTIVE CONTROL IS ASSOCIATED WITH MORE PRONOUNCED ACHIEVEMENT OF TARGET BLOOD PRESSURE AND REDUCED EMERGENCY CALLS

Abstract

Objective: The aim of the study was to evaluate the influence of the distance control of blood pressure on the efficacy of treatment, frequency of emergency calls in patients with arterial hypertension (AH) in Voronezh out-patient clinic. Design and method: 249 patients with AH (31% men, age 59 ± 6.1 years, AH duration 12 ± 4.2 years, smokers 7%, obesity 31%) were openly randomized in 2 groups. In the intervention group patients (n = 127) were under active distance physicians’ control and in the control group patients (n = 122) received routine standard care. Patients in the intervention group reported the physician the results of home blood pressure monitoring (HBPM) by phone or E-mail daily (weekly in patients with target BP) and antihypertensive therapy was changed accordingly. Achievement of target BP level and number of emergency calls were assessed in 12 months. Results: In the intervention group BP decreased from 158.2 ± 15.4 to 142.1 ± 13.7 mmHg, proportion of patients with target BP increased from 32 to 82% (p < 0.001). In the control group BP decreased from157.9 ± 16.1 to 154.8 ± 12.7 mmHg, proportion of patients with target BP increased from 33 to 50%(p < 0.01). The number of emergency ambulance calls with hypertensive crises was significantly less in the intervention group (108 vs 186, p < 0.01). Conclusions: The active distance control with modification of antihypertensive therapy based on HBPM compared with routine practice significantly increased the proportion of patients with target BP and decreased the amount of the emergency ambulance calls.