Telemonitoring improves nutrient intakes and blood pressure (BP) in urban African American (AA) over usual clinic care.

Abstract

High BP affects AAs more than Whites. In urban health care settings, barriers to clinic visits for care and diet education exist. In this study, 327 urban AAs were randomized to either usual care (UC) (n = 161, 60.3 ± 12.1 years old) or home BP telemonitoring plus usual care (TM) (n = 166, 59.0 ± 13.1 years old). Participants in TM monitored their BP 3 times/week and received weekly feedback about BP and dietary counseling over the telephone. Three-day diet recalls were collected. At 3 month follow-up, both groups lowered their BP, but TM group reduced more than the UC group (SBP: TM=−14±2 mmHg, UC=−5±2; DBP: TM=−7±1, UC=−2±1, p's<.01). The TM group reduced their intakes (I) of total, saturated (SAT), monounsaturated fat (p<.01), % energy from fat, cholesterol, and calcium (p<.05). Reduction in polyunsaturated fat (PUFA) and sodium, and increase in fruit servings approached significance. Servings of grain (r=−0.203, p<.05) and % fat (r=0.183, p <.05) were correlated with SBP for the TM. No correlations were found between diet and DBP. In the UC group, DBP was related to the change in calcium I (r=0.199, p<.05). Male, but not in female, participants in all groups showed relationships between SBP and changes in the I of energy, total fat, SAT and PUFA. Thus, while improvement was made with UC, TM improves dietary I and BP to a greater extent. This intervention is adaptable in other urban settings and may advance BP care.