What is the clinical evidence from this study?

Study design: Cross-Sectional. Population: Hypertension (n=6141). Intervention: Telecardiology consultations. Primary outcome: Blood pressure (BP) improvement (p=<0.05).

September 30, 2025

Telecardiology Management of Hypertension in Brazilian Remote Populations

Q: What are the key findings of this study?

Telecardiology management of hypertension in remote areas significantly improved blood pressure during follow-ups (p<0.05) and required tertiary care referral in only 0.56% of cases.

Key Result

Telecardiology management of hypertension in remote areas significantly improved blood pressure during follow-ups (p<0.05) and required tertiary care referral in only 0.56% of cases.

Study Design

Type

Cross-Sectional (n=6,141)

Multicenter

Yes

Structured PICO

Does telecardiology improve blood pressure control and management in adult patients with hypertension in remote areas?

Population

Patients over 18 years old with a primary diagnosis of hypertension referred to telecardiology from 365 primary health care facilities in North and Midwest Brazil. n=6,141 telemedicine encounters (4,706 first visits), mean age 60.31, 59.5% female.

Intervention

Real-time outpatient telecardiology consultations involving cardiologists, primary care physicians, and patients.

Outcome

Blood pressure levels, diagnostic tests, medication adjustments, and follow-up outcomes including referrals to tertiary care.surrogate

Telecardiology consultations for hypertension in remote areas are associated with significant improvements in blood pressure and low rates of tertiary care referral.

Main Result

p-value: p=<0.05

Limitations

Lack of data on long-term clinical outcomes
Scalability needs further assessment

Abstract

Background: Hypertension is highly prevalent worldwide, burdening health systems with inadequate control. Managing hypertension in remote areas of developing countries presents significant challenges. Telemedicine can enhance access to cardiologists and improve treatment adherence. Objective: To assess the effectiveness of telecardiology in managing hypertension in these regions, which remains inadequately understood. Methods: This retrospective cross-sectional study analyzed telecardiology consultations from a single center serving 365 primary health care facilities in North and Midwest Brazil. Patients over 18 years old who were referred to telecardiology and had a primary diagnosis of hypertension. Cardiologists, primary care physicians, and patients participated in real-time outpatient consultations, and data on demographics, blood pressure (BP) levels, diagnostic tests, medication adjustments, and follow-up outcomes were collected. Results: Among 6,141 telemedicine encounters, 4,706 (76.63%) were first visits, and 1,435 (23.37%) were follow-ups. The mean age was 60.31 ± 13.81 years, and 3,657 (59.5) were female. Cardiovascular risk factors were common, including diabetes (24.5%), obesity (24.2%), and smoking (39.4%). Most were handled with basic testing, and only 2.39% had interventions proposed for the possibility of secondary hypertension. Medication adjustments took place in 43.9% of consultations. BP improved significantly in follow-ups ( p < 0.05). Most patients (81.97%) needed at least one telemedicine follow-up. Only 0.56% were referred to tertiary care. Conclusion: Telecardiology optimizes hypertension management by enhancing BP control, diagnostic workups, and therapeutic adjustments while decreasing referrals to tertiary care. These findings underscore its potential to reduce health care disparities in underserved areas. Further research is necessary to assess long-term clinical outcomes and scalability.

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