Self-monitoring Of Blood Pressure Research Articles

Assessment of the comparative efficiency of treatment with angiotensin-converting enzyme inhibitor and angiotensin II receptor blockers in patients who are old and senile with stage 3, grade 2–3 hypertension

BACKGROUND: The problem of sex differences in the treatment of hypertension is currently relevant because of the different disease course in men and women. Particular attention should be paid to the age aspect of the problem, since the clinical and hemodynamic parameters of arterial hypertension (AH) in patients who are old and senile have their specifics.
 AIM: This study aimed to assess the sex aspect of the comparative efficiency of the angiotensin-converting enzyme inhibitor (ACEI) perindopril and angiotensin II receptor blockers (ARB) losap, losartan, and lorista patients who are old and senile with stage 3, grade 23 hypertension.
 MATERIALS AND METHODS: A total of 185 patients with stage 3, grade 23 hypertension were examined. Two randomized groups of patients were formed depending on the therapy received. Group 1 received ACEI (perindopril), and group 2 patients received ARBs (lozap, losartan, and lorista). Patients kept a diary in which the amount and types of pain, dizziness, and heart palpitations were noted. In addition, the Health, Activity, and Mood Questionnaire and daily self-monitoring of blood pressure every 3 h during the hospital stay and for 23 months after discharge were used. The obtained information was processed using variation statistics and the difference method.
 RESULTS: The analysis of the comparative efficiency of ARBs and ACEIs revealed significant sex differences in hemodynamic parameters. The ARB group of drugs showed a more pronounced decrease in 24-h blood pressure monitoring (24-h BPM) and the number of pain episodes in the heart area in women compared with men. When using ACEI, no sex difference in the decrease in 24-h BPM indicators was observed. However, significant differences in clinical symptoms of both men and women were found. In women, compared with men, ACEIs had a greater positive effect on the subjective state in points (according to the Health, Activity, and Mood Questionnaire).
 CONCLUSIONS: The results suggest that ARB therapy for women who are old and senile with stage 3, grade 23 hypertension. For men of a similar age with this pathology, therapy with both ACEIs and ARBs may be recommended.

Acceptance of a Connected Blood Pressure Monitor in the Diagnosis of Hypertension in Rural Areas: An Exploratory Study in France

Home medical devices are increasingly proving their usefulness to the general public, particularly in medical deserts such as rural areas and also in the diagnosis of hypertension (e.g., telemedicine practice requesting self-measurement of blood pressure), nevertheless, this product is not always well received by the population. The objective of this study is to analyze the acceptance of a connected blood pressure monitor in order to understand the factors that will impact its integration in the activity of its appropriation. Twenty patients living in rural areas awaiting diagnosis of hypertension responded to the UTAUT questionnaire after performing self-monitoring of blood pressure for 3 consecutive days. Our results suggest that the intentions of use are related to the 3 main dimensions of the UTAUT, i.e. expected performance (or perceived usefulness), effort expectancy (or perceived ease-of-use), social influence. Effort Expectancy is also strongly correlated to the attitude toward the device. Nevertheless, age, gender, technophilia, self-efficacy and anxiety are not correlated with usage intentions. These results suggest that the intention to use the blood pressure monitor that may impact actual use is determined more by its usefulness (functions, etc.) and ease of use than by socio-demographic characteristics. This is particularly encouraging insofar as these medical devices are a priori accepted by a population with variable characteristics (age, etc.) providing that they are properly designed to be perceived as useful and usable.

SA45 The Effect of Team-Based Care Strategies on Systolic Blood Pressure at Six Months: A Meta-Analysis

Team-based hypertension care (TBC) reduces systolic blood pressure (SBP) and can lower the risk of cardiovascular disease. This meta-analysis assessed the impact of TBC with and without self-monitoring of blood pressure (SMBP) or physician vs. non-physician titration of antihypertensive medications on SBP at 6 months.

Self-monitoring of psychological stress-induced blood pressure in daily life using a wearable watch-type oscillometric device in working individuals with hypertension

This study investigated psychological stress-induced blood pressure (BP) elevation according to self-measured data obtained by a wearable watch-type oscillometric device for multiple days in 50 working hypertension patients (mean ± SD age: 60.5 ± 8.9 years; 92.0% men; 96% treated for hypertension). Participants were asked to self-measure their BPs at five predetermined times as well as at any additional time points at their own discretion under ambulatory conditions for a maximum of 7 days. At the time of each BP measurement, participants self-reported their location, emotion, and degree of stress. A total of 1220 BP readings with self-reported situational information were obtained from 50 participants over 5.5 ± 1.2 days. Systolic BP (SBP) and diastolic BP (DBP) measured during moments of self-reported negative emotions (i.e., anger, tension, anxiety, or sadness) were significantly higher (5.0 ± 1.3 and 2.0 ± 0.8 mmHg, both p < 0.05) than those during moments of self-reported positive emotions (i.e., happiness or calm). SBP/DBP were significantly increased under a moderate or high degree of stress by [4.5 ± 1.1]/[2.5 ± 0.7] and [10.2 ± 3.0]/[4.7 ± 1.8] mmHg, respectively. As a result, it was estimated that SBP/DBP increased 15.2/8.5 mmHg in the presence of highly stressful negative emotions. In conclusion, self-measurement of BP monitoring with a wearable device for multiple days is a feasible method to detect daily stress-induced BP elevation in working adults.

SIMPLIFIED REGIMEN FOR THE MANAGEMENT OF HYPERTENSION WITH TELEMEDICINE AND BLOOD PRESSURE SELF-MONITORING (SIMPLE): STUDY PROTOCOL FOR A RANDOMIZED CONTROLLED TRIAL

Objective: Telemedicine and blood pressure (BP) self-monitoring conduces to management of hypertension. Recent hypertension guidelines highly recommended single-pill-combination (SPC) for the initial treatment of essential hypertension. Based on this fact, an SPC-based telemedicine titration regimen with BP self-monitoring could be a better way in managing hypertension. This trial aims to elucidate whether telemedicine combined with BP self-monitoring is superior to self-monitoring alone during hypertension management. Design and method: This study will be a multi-centered, open-labelled, randomized controlled trial. A minimum sample of 358 hypertensive patients with uncontrolled BP from four centers will be included. The intervention group will include BP self-monitoring and tele-monitoring plus a free SPC-based telemedicine titration therapy for 6 months, they will be recommended to take BP measurements at least once every seven days, in the meantime, researchers will call to give a consultation on lifestyle or titration advice once a fortnight. The control group will be required to self-monitor BP at the same time interval as intervention group, without any therapy change. Primary outcome of the trial will be the difference in SBP at 6-month follow-up between intervention and control group, adjusted for baseline variables. Secondary outcomes such as BP control rate, major adverse cardiovascular events, medication adherence, quality of life will be investigated. Results: Ongoing study, no further results to share at this time. Conclusions: Ongoing study, no further results to share at this time.

AWARENESS OF RISK FACTORS AND COMPONENTS OF LIFESTYLE MODIFICATION IN ELDERLY PATIENTS WITH CARDIOVASCULAR COMORBIDITY AND CHRONIC KIDNEY DISEASE

Objective: Chronic kidney disease (CKD) is a significant risk factor for cardiovascular disease and cardiovascular mortality. Timely prevention and diagnosis of CKD in risk groups, primarily in elderly patients with cardiovascular comorbidity, is very important. The aim of this study was to investigate awareness of risk factors and components of lifestyle modification in elderly patients with cardiovascular comorbidity and CKD. Design and method: 214 elderly patients with stable cardiovascular diseases (106 males, mean age 69.5 ± 7.6 years) were studied. CKD was diagnosed and classified according to the KDIGO guidelines (2012).Awareness of risk factors and components of lifestyle modification were assessed through questionnaires and interviews. Results: CKD with glomerular filtration rate (GFR) less than 60 ml/min/1.73 m2(CKD-EPI, 2011) was diagnosed in 144 (67.3%) patients. Only one third of elderly patients with cardiovascular diseases and CKD (33.3%) were aware of their impaired renal function. 18 (12.5%) elderly patients with CKD did not have constant monitoring by medical specialists. Most of the patients had arterial hypertension - 201 (93.9%). Awareness of risk factors and components of lifestyle modification in elderly patients with cardiovascular comorbidity did not differ depending on the presence of CKD (p &gt; 0.05). 181 (84.6%) elderly patients were informed about the benefits of salt restriction, 193 (90.2%) - about the benefits of daily eating vegetables and fruits, 165 (77,1%) - on the need for physical activity. 173 (80.8%) elderly patients with cardiovascular comorbidity never smoked and 178 (83.2%) - very rarely consume alcohol. Only half of elderly patients knew the level of total cholesterol (51.4%) and their cardiovascular risk (45.8%). Majority of elderly patients with cardiovascular comorbidity (95.8%) had home blood pressure monitor regardless of the presence of CKD. Every fourth patient (26.2%) kept a diary of blood pressure self-monitoring. Every fourth of elderly patient (26.6%) never controls blood pressure at home. Conclusions: Elderly patients with cardiovascular comorbidity and CKD are well informed about the components of lifestyle modification. only half of elderly patients are aware of their cholesterol levels and cardiovascular risk and engage in self-monitoring of blood pressure, despite the presence of cardiovascular diseases and CKD.

IS HOME BLOOD PRESSURE SELF MONITORING HERE TO STAY? AN EVALUATION OF PATIENT SATISFACTION WITH HOME BLOOD PRESSURE MONITORING IN A RURAL POPULATION DURING THE COVID PANDEMIC

Objective: During the COVID pandemic patients with hypertension were trained to self-monitor blood pressures at home. A post service transformation evaluation was undertaken as COVID restrictions were eased to assess if patients would prefer office blood pressure vs home monitoring for ongoing care. Design and method: A retrospective analysis of all patients who consented to home blood monitoring during the COVID pandemic was undertaken at 12 months across three health centre in a rural population. Patients were asked of their perception of doing home blood pressure readings and their confidence and satisfaction with this method vs office. Method: Patients were asked during routine medication reviews and at the end of 12 months of their confidence and satisfaction and difficulties with managing home blood pressure monitoring in order to understand their preferences for future care Results: Of the total of over 2000 patients with known diagnosis of hypertension n = 2000, a sample cohort of 500 patients (sample size 25%) were asked as they had medication reviews of their confidence with the self-monitoring. The no of patients who felt confident and wished to continue was quite high 70% this did not vary across the ages i.e. both young and the elderly were content doing their own home blood readings. Only 50 patients (11.8%) wanted office readings reasons were affordability and lack of confidence with the reliability of home readings and those who were very elderly wanted the human contact which they previously had. Conclusions: Home blood pressure self-monitoring is a safe reliable and evidenced based and previously underutilized method of monitoring patients with hypertension. We believe the office readings of blood pressure still have a place in routine care but the overwhelming response and satisfaction with home blood pressure is likely to change monitoring and lead to better overall blood pressure control.

Self-monitoring of blood pressure among women with hypertensive disorders of pregnancy: a systematic review

BackgroundThe World Health Organization (WHO) recommends self-monitoring of blood pressure (SMBP) for hypertension management. In addition, during the COVID-19 response, WHO guidance also recommends SMBP supported by health workers although more evidence is needed on whether SMBP of pregnant individuals with hypertension (gestational hypertension, chronic hypertension, or pre-eclampsia) may assist in early detection of pre-eclampsia, increase end-user autonomy and empowerment, and reduce health system burden. To expand the evidence base for WHO guideline on self-care interventions, we conducted a systematic review of SMBP during pregnancy on maternal and neonatal outcomes.MethodsWe searched for publications that compared SMBP with clinic-based monitoring during antenatal care. We included studies measuring any of the following outcomes: maternal mortality, pre-eclampsia, long-term risk and complications, autonomy, HELLP syndrome, C-section, antenatal hospital admission, adverse pregnancy outcomes, device-related issues, follow-up care with appropriate management, mental health and well-being, social harms, stillbirth or perinatal death, birthweight/size for gestational age, and Apgar score. After abstract screening and full-text review, we extracted data using standardized forms and summarized findings. We also reviewed studies assessing values and preferences as well as costs of SMBP.ResultsWe identified 6 studies meeting inclusion criteria for the effectiveness of SMBP, 6 studies on values and preferences, and 1 study on costs. All were from high-income countries. Overall, when comparing SMBP with clinic-monitoring, there was no difference in the risks for most of the outcomes for which data were available, though there was some evidence of increased risk of C-section among pregnant women with chronic hypertension. Most end-users and providers supported SMBP, motivated by ease of use, convenience, self-empowerment and reduced anxiety. One study found SMBP would lower health sector costs.ConclusionLimited evidence suggests that SMBP during pregnancy is feasible and acceptable, and generally associated with maternal and neonatal health outcomes similar to clinic-based monitoring. However, more research is needed in resource-limited settings.Systematic review registrationPROSPERO CRD42021233839.

Effect of Self-monitoring of Blood Pressure on Diagnosis of Hypertension During Higher-Risk Pregnancy

Inadequate management of elevated blood pressure (BP) is a significant contributing factor to maternal deaths. Self-monitoring of BP in the general population has been shown to improve the diagnosis and management of hypertension; however, little is known about its use in pregnancy. To determine whether self-monitoring of BP in higher-risk pregnancies leads to earlier detection of pregnancy hypertension. Unblinded, randomized clinical trial that included 2441 pregnant individuals at higher risk of preeclampsia and recruited at a mean of 20 weeks' gestation from 15 hospital maternity units in England between November 2018 and October 2019. Final follow-up was completed in April 2020. Participating individuals were randomized to either BP self-monitoring with telemonitoring (n = 1223) plus usual care or usual antenatal care alone (n = 1218) without access to telemonitored BP. The primary outcome was time to first recorded hypertension measured by a health care professional. Among 2441 participants who were randomized (mean [SD] age, 33 [5.6] years; mean gestation, 20 [1.6] weeks), 2346 (96%) completed the trial. The time from randomization to clinic recording of hypertension was not significantly different between individuals in the self-monitoring group (mean [SD], 104.3 [32.6] days) vs in the usual care group (mean [SD], 106.2 [32.0] days) (mean difference, -1.6 days [95% CI, -8.1 to 4.9]; P = .64). Eighteen serious adverse events were reported during the trial with none judged as related to the intervention (12 [1%] in the self-monitoring group vs 6 [0.5%] in the usual care group). Among pregnant individuals at higher risk of preeclampsia, blood pressure self-monitoring with telemonitoring, compared with usual care, did not lead to significantly earlier clinic-based detection of hypertension. ClinicalTrials.gov Identifier: NCT03334149.

Effect of Self-monitoring of Blood Pressure on Blood Pressure Control in Pregnant Individuals With Chronic or Gestational Hypertension

Inadequate management of elevated blood pressure is a significant contributing factor to maternal deaths. The role of blood pressure self-monitoring in pregnancy in improving clinical outcomes for the pregnant individual and infant is unclear. To evaluate the effect of blood pressure self-monitoring, compared with usual care alone, on blood pressure control and other related maternal and infant outcomes, in individuals with pregnancy hypertension. Unblinded, randomized clinical trial that recruited between November 2018 and September 2019 in 15 hospital maternity units in England. Individuals with chronic hypertension (enrolled up to 37 weeks' gestation) or with gestational hypertension (enrolled between 20 and 37 weeks' gestation). Final follow-up was in May 2020. Participants were randomized to either blood pressure self-monitoring using a validated monitor and a secure telemonitoring system in addition to usual care (n = 430) or to usual care alone (n = 420). Usual care comprised blood pressure measured by health care professionals at regular antenatal clinics. The primary maternal outcome was the difference in mean systolic blood pressure recorded by health care professionals between randomization and birth. Among 454 participants with chronic hypertension (mean age, 36 years; mean gestation at entry, 20 weeks) and 396 with gestational hypertension (mean age, 34 years; mean gestation at entry, 33 weeks) who were randomized, primary outcome data were available from 444 (97.8%) and 377 (95.2%), respectively. In the chronic hypertension cohort, there was no statistically significant difference in mean systolic blood pressure for the self-monitoring groups vs the usual care group (133.8 mm Hg vs 133.6 mm Hg, respectively; adjusted mean difference, 0.03 mm Hg [95% CI, -1.73 to 1.79]). In the gestational hypertension cohort, there was also no significant difference in mean systolic blood pressure (137.6 mm Hg compared with 137.2 mm Hg; adjusted mean difference, -0.03 mm Hg [95% CI, -2.29 to 2.24]). There were 8 serious adverse events in the self-monitoring group (4 in each cohort) and 3 in the usual care group (2 in the chronic hypertension cohort and 1 in the gestational hypertension cohort). Among pregnant individuals with chronic or gestational hypertension, blood pressure self-monitoring with telemonitoring, compared with usual care, did not lead to significantly improved clinic-based blood pressure control. ClinicalTrials.gov Identifier: NCT03334149.

Self-monitoring of Blood Pressure During Pregnancy

Self-monitoring of Blood Pressure During Pregnancy

Telehealth Blood Pressure Monitoring Models In Hypertensive Patients: A Scoping Review

The main global cause of death in the world is non-communicable diseases (NCDs). One of NCD is hypertension. Increased hypertension during the Covid-19 pandemic is associated with risk factors for lifestyle changes, social restrictions, lack of physical activity, and stress. Therefore, a remote blood pressure control system is needed to monitor the patient’s health status. The purpose of writing this literature review is to provide an overview of health care practices with remote monitoring of blood pressure of hypertension patients based on online management with telemonitoring. the method used is scoping review with the inclusion criteria of articles were published from 2017 – 2021, used the research designs of Randomized Control Trial and Study Experimental, and were published in English and Indonesian. Articles selections were using PRISMA Flow Diagram 2009 and selection for eligibility were using. The Joanna Briggs Institute Critical Appraisal. Four articles were included in the study and 1037 articles were excluded from the study. It was found that telehealth blood pressure monitoring carried out in hypertensive patients was home and online blood pressure management, TASMINH (Telemonitoring and Self-Management in the Control of Hypertension), and scale-up blood pressure. Telemonitoring was found to be significant in reducing and monitoring patients with home care-based hypertension Self-Monitoring Blood Pressure (SMBP) at home using a digital sphygmomanometer accompanied by direct monitoring of doctors and nurses via the internet can be a solution for monitoring blood pressure during a pandemic.

GESTATIONAL DIABETES AS A POSSIBLE PREDICTOR OF LATE PREECLAMPSIA

Abstract. Purpose of the study - We assessed the impact of gestational diabetes on the development of preeсlampsia. Material and methods of research: We conducted a retrospective case-control study. Group I included 34 patients with preeclampsia, group II included 66 patients without preeclampsia. We analyzed the course of pregnancy and the development of gestational diabetes. Research results. In the group of patients with late preeclampsia (after 34 weeks of pregnancy), we found a high incidence of gestational diabetes mellitus. The frequency of gestational diabetes was noted in 56% of cases, while in the group of healthy pregnant women, the incidence of this pathology is 4.55% as the average in the population. Conclusions. Gestational diabetes mellitus can be considered one of the predictors of late preeclampsia. The course of diabetes is associated with progressive endothelial dysfunction, which can aggravate the existing compensated placental ischemia, which is one of the important pathogenetic links in the implementation of preeclampsia. We recommend explaining not only the risks of the underlying disease, but also careful self-monitoring of blood pressure at home in patients with diabetes. We also recommend testing for preeclampsia after detection of gestational diabetes mellitus (placental growth factor/fms-like soluble tyrosine kinase-1), which provides information on the likely debut of a hypertensive disorder within 4 weeks ahead.

Mobile health technology for hypertension management with Hmong and Latino adults: mixed-methods community-based participatory research

ABSTRACT Objective To identify Hmong and Latino adults’ perspectives about a mHealth-based care model for hypertension (HTN) management involving blood pressure (BP) self-monitoring, electronic transmission of BP readings, and responsive HTN medication adjustment by a provider team. Design We conducted a mixed-methods formative study with 25 Hmong and 25 Latino participants with HTN at an urban federally-qualified health center. We used a tool to assess HTN knowledge and conducted open-ended interviews to identify perspectives about mHealth-based care model. Results While most participants agreed that lowering high blood pressure decreased the risk of strokes, heart attacks, and kidney failure, there were gaps in medical knowledge. Three major themes emerged about the mHealth-based care model: (1) Using mHealth technology could be useful, especially if assistance was available to patients with technological challenges; (2) Knowing blood pressures could be helpful, especially to patients who agreed with doctors’ medical diagnosis and prescribed treatment; (3) Transmitting blood pressures to the clinic and their responsive actions could feel empowering, and the sense of increased surveillance could feel entrapping. Some people may feel empowered since it could increase patient-provider communication without burden of clinic visits and could increase involvement in BP control for those who agree with the medical model of HTN. However, some people may feel entrapped as it could breach patient privacy, interfere with patients’ lifestyle choices, and curtail patient autonomy. Conclusions In general, Hmong and Latino adults responded positively to the empowering aspects of the mHealth-based care model, but expressed caution for those who had limited technological knowledge, who did not agree with the medical model and who may feel entrapped. In a shared decision-making approach with patients and possibly their family members, health care systems and clinicians should explore barriers and potential issues of empowerment and entrapment when offering a mHealth care model in practice.

Simplified regimen for the management of hypertension with telemedicine and blood pressure self-monitoring (SIMPLE): study protocol for a randomised controlled trial

IntroductionTelemedicine and blood pressure (BP) self-monitoring conduces to management of hypertension. Recent hypertension guidelines highly recommended single pill combination (SPC) for the initial treatment of essential hypertension. Based on this...

Prospects for developing and implementing remote blood pressure monitoring in patients under dispensary follow-up

Recently, the use of telemedicine technologies (TMT) in the healthcare has gained great importance. TMT is one of the ways to increase the healthcare availability, including in patients with high blood pressure (BP). Office BP measurement and 24-hour BP monitoring are not accurate enough to study natural or induced BP changes over long periods of time. For the selection of antihypertensive drugs and the diagnosis of hypertension (HTN) in patients with an emotionally unstable personality type, as well as in the differential diagnosis of normotension, preHTN, BP selfmonitoring comes first. The use of BP self-monitoring for the diagnosis, selection of therapy, assessment of adherence and effectiveness of treatment of HTN is more effective with remote, socalled telemetric, dynamic BP monitoring. The article presents world experience in the effective use of dynamic remote BP monitoring using TMT.

Blood Pressure Monitoring as a Digital Health Tool for Improving Diabetes Clinical Outcomes: Retrospective Real-world Study.

BackgroundRemote data capture for blood glucose (BG) or blood pressure (BP) monitoring and the use of a supportive digital app are becoming the model in diabetes and hypertension chronic care. One of the goals in chronic condition management is to increase awareness and generate behavioral change in order to improve outcomes in diabetes and related comorbidities, such as hypertension. In addition, there is a lack of understanding of the association between BG and BP levels when using digital health tools.ObjectiveBy applying a rigorous study framework to digital health data, this study investigated the relationship between BP monitoring and BG and BP levels, as well as a lagged association between BP and BG. We hypothesized that during the first 6 months of BP monitoring, BG and BP levels would decrease. Finally, we suggested a positive association between BP levels and the following month’s BG levels.MethodsIn this retrospective, real-world case-control study, we extracted the data of 269 people with type 2 diabetes (T2D) who tracked their BG levels using the Dario digital platform for a chronic condition. We analyzed the digital data of the users who, in addition to BG, monitored their BP using the same app (BP-monitoring [BPM] group, n=137) 6 months before and after starting their BP monitoring. Propensity score matching established a control group, no blood pressure monitoring (NBPM, n=132), matched on demographic and baseline clinical measures to the BPM group. A piecewise mixed model was used for analyzing the time trajectories of BG, BP, and their lagged association.ResultsAnalysis revealed a significant difference in BG time trajectories associated with BP monitoring in BPM and NBPM groups (t=–2.12, P=.03). The BPM group demonstrated BG reduction improvement in the monthly average BG levels during the first 6 months (t=–3.57, P<.001), while BG did not change for the NBPM group (t=0.39, P=.70). Both groups showed similarly stable BG time trajectories (B=0.98, t=1.16, P=.25) before starting the use of the BP-monitoring system. In addition, the BPM group showed a significant reduction in systolic (t=–6.42, P<.001) and diastolic (t=–4.80, P<.001) BP during the first 6 months of BP monitoring. Finally, BG levels were positively associated with systolic (B=0.24, t=2.77, P=.001) and diastolic (B=0.30, t=2.41, P=.02) BP.ConclusionsThe results of this study shed light on the association between BG and BP levels and on the role of BP self-monitoring in diabetes management. Our findings also underscore the need and provide a basis for a comprehensive approach to understanding the mechanism of BP regulation associated with BG.

Daily self-monitoring of blood pressure decreases systolic and diastolic blood pressure in hypertensive participants.

Hypertension is a major risk factor for cardiovascular diseases, and behavior modification has been shown to improve blood pressure (BP). We investigated whether daily self-monitoring of systemic BP and other factors related to cardiovascular events decreased BP in hypertensive participants. In this prospective, randomized, open, blinded-endpoint trial, we assigned 161 participants with hypertension to monitor their BP daily (BP-measurement group) or, in addition to BP, monitor their body fat, sleeping time, and daily step count (multiple-measurement group) or no self-monitoring (control group) for 2months. The primary endpoint was the absolute change in systolic BP from baseline to 2months after assignment. There were no differences in the baseline age and gender ratios among the three groups. After 2months, systolic BP in the morning was unchanged in the control group, at a median of 149mmHg [interquartile range (IQR) 136-164] from 150mmHg (IQR 138-164), and was significantly decreased to 139mmHg (IQR 125-148) from 142mmHg (IQR 131-157) in the BP-measurement group. BP did not further decrease in the multiple-measurement group, 134mmHg (IQR 121-146) from 141mmHg (IQR 131-157). Daily self-monitoring of BP decreased the BP of participants with hypertension, but additional daily self-monitoring of body fat, sleeping time, and daily step count did not further decrease BP. This behavior modification merits use as a nonpharmacological hypertension treatment.

The role of non-drug methods of increasing adherence to the treatment of patients with arterial hypertension in a polyclinic

Introduction. Arterial hypertension (AH) is one of the important high-risk factors for the development of heart diseases, but its diagnosis and treatment does not require high technologies and substantial costs. However, the asymptomatic course of AH combined with a low level of medical literacy contributes to low adherence to treatment.Aim. To study the indirect impact of remote blood pressure monitoring (RBPM), the introduction of educational materials (EMs) in comparison with self-monitoring of blood pressure (SMBP) on adherence of patients with AH to outpatient treatment.Materials and methods. 60 subjects with an established fact of partial or complete refusal to use antihypertensive therapy were enrolled in the study and randomized into four equal and comparable groups: 1 – SMBP, 2 – RBPM, 3 – SMBP + EMs, 4 – RBPM + EMs. The impact of using RBPM was assessed by comparing blood pressure values in groups 1 and 2; the impact of EM – by comparing the results of questionnaire surveys in groups 1 and 2 and groups 3 and 4.Results and discussion. Additional training of patients with AH contributed to a twofold increase in adherence in using SCAD and RBPM. The average systolic blood pressure in groups 1 and 2 was 134 mm Hg, in groups 3 and 4 – 129 mm Hg; diastolic blood pressure in groups 1 and 2 – 78.5 mm Hg, in groups 3 and 4 – 77.5 mm Hg.Conclusion. The maximum impact on adherence to AH treatment can be achieved with the introduction of a set of measures. However, the introduction of RBPM has a number of limitations associated with the additional economic burden and the lack of an approved methodology. However, the provision of treatment and prevention facilities with EMs does not require additional development of methodology and is significantly cheaper than the cost of modern blood pressure monitors.

Self-Monitoring of Blood Pressure and Feed-back Using APP in TReatment of UnconTrolled Hypertension (SMART-BP): A Randomized Clinical Trial.

Self-monitoring of blood pressure (SMBP) is a reliable method used to assess BP accurately. However, patients do not often know how to respond to the measured BP value. We developed a mobile application-based feed-back algorithm (SMBP-App) for tailored recommendations. In this study, we aim to evaluate whether SMBP-App is superior to SMBP alone in terms of BP reduction and drug adherence improvement in patients with hypertension. Self-Monitoring of blood pressure and Feed-back using APP in TReatment of UnconTrolled Hypertension (SMART-BP) is a prospective, randomized, open-label, multicenter trial to evaluate the efficacy of SMBP-App compared with SMBP alone. Patients with uncomplicated essential hypertension will be randomly assigned to the SMBP-App (90 patients) and SMBP alone (90 patients) groups. In the SMBP group, the patients will perform home BP measurement and receive the standard care, whereas in the SMBP-App group, the patients will receive additional recommendations from the application in response to the obtained BP value. Follow-up visits will be scheduled at 12 and 24 weeks after randomization. The primary endpoint of the study is the mean home systolic BP. The secondary endpoints include the drug adherence, the home diastolic BP, home and office BP. SMART-BP is a prospective, randomized, open-label, multicenter trial to evaluate the efficacy of SMBP-App. If we can confirm its efficacy, SMBP-App may be scaled-up to improve the treatment of hypertension. ClinicalTrials.gov Identifier: NCT04470284.