Key result
Home BP telemonitoring with automated transmission lowers office SBP by ~6 mm Hg vs usual care.
Why the study?
Recent advances in digital technology allowing automatic home blood pressure telemonitoring data transmission without patient input prompted a summary of the latest evidence on this approach.
Does home blood pressure telemonitoring with automatic data transmission reduce blood pressure in hypertension patients compared to usual management?
Meta-Analysis (n=5,743)
Does home blood pressure telemonitoring with automatic data transmission reduce blood pressure in hypertension patients compared to usual management?
Effect estimate: Mean difference -6.0 mm Hg (95% CI -8.9 to -3.1)
p-value: p=<0.001
Home blood pressure telemonitoring with automatic data transmission, particularly via smartphone apps, significantly improves blood pressure reduction compared to usual care.
Supports integration of automatic home BP telemonitoring into hypertension care; reinforces Level 1 evidence for digital interventions.
Aims Home blood pressure telemonitoring (HBPT) is a useful way to manage BP. Recent advances in digital technology to automatically transmit BP data without the patient input may change the approach to long-term BP treatment and follow-up. The purpose of this review is to summarize the latest data on the HBPT with automatic data transmission. Methods and results Articles in English from 1980 to 2021 were searched by electronic databases. Randomized controlled trials comparing HBPT with automatic data transmission with usual BP management and including systolic BP (SBP) and/or diastolic BP (DBP) as outcomes in hypertension patients were included in the systematic review. A meta-analysis was conducted. After removing duplicates, 474 papers were included and 23 papers were identified. The HBPT with automatic data transmission had a significant beneficial impact on BP reduction (mean difference for office SBP −6.0 mm Hg; P < 0.001). Subgroup analyses showed that the studies using smartphone applications reduced BP significantly more in the intervention group than in the control group (standardized mean difference for office and home SBP −0.25; P = 0.01) as did the studies using HBPT other than the applications. Longer observation periods showed a sustained effect, and multidisciplinary cooperation was effective. Conclusion This review suggests that a care path based on HBPT with automatic data transmission can be more effective than classical management of hypertension. In particular, the studies using smartphone applications have shown beneficial effects. The results support the deployment of digital cardiology in the field of hypertension management.
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Kaihara et al. (2022) conducted a meta-analysis in Hypertension (n=5,743). Home blood pressure telemonitoring (HBPT) with automatic data transmission vs. Usual blood pressure management was evaluated on Office systolic blood pressure (SBP) change (Mean difference -6.0 mm Hg, 95% CI -8.9 to -3.1, p=<0.001). Home blood pressure telemonitoring with automatic data transmission significantly reduced office systolic blood pressure by a mean difference of 6.0 mm Hg compared to usual care.
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