Why the study?
While remote home blood pressure monitoring is effective in underserved areas, its effects in urban hypertensive patients with easier access to high-quality medical services remain unclear.
Does remote home blood pressure monitoring improve blood pressure control compared to face-to-face care in urban hypertensive patients?
Does remote home blood pressure monitoring improve blood pressure control compared to face-to-face care in urban hypertensive patients?
Remote blood pressure monitoring provides only small, clinically irrelevant improvements in blood pressure reduction compared to standard face-to-face care in urban hypertensive patients.
Answers are grounded in this paper and cite their sources.
RBPM adds no clear benefit over usual care in urban hypertension; challenges extension of underserved-area benefits and leaves urban-specific optimization open.
Background: Remote home blood pressure monitoring (RBPM) has been shown as effective in managing hypertension in underserved areas. Effects on urban patients, who are more easily provided with high-quality medical services, are still unclear. We systematically review previously published randomized controlled trials on the effect of RBPM for urban hypertensive patients. Methods: We searched electronic databases for studies published in English up to October 2018. Studies comparing the use of RBPM to face-to-face care were included. Outcome measures were changes in office blood pressure (BP) and the rate of BP control. Results: We identified 1,433 potential references for screening, of which 27 were eligible for review. Substantial heterogeneity was evident for the investigated variables. A significant standardized mean difference (SMD) was observed for RBPM for systolic BP, but the effect size was small compared to face-to-face care and was clinically irrelevant in avoiding cardiovascular events (0.212, 95% confidence interval 0.148–0.275; p < 0.001). For diastolic BP, the SMD between the two groups was small (0.170, p < 0.001) and the effect of RBPM was irrelevant in preventing cardiovascular events. The effect on the rate of BP control was significantly high for the intervention group (relative risk: 1.136; p = 0.018). Conclusions: This review demonstrates that RBPM performed on urban hypertensive patients has limited value and seems not to be superior to ordinary care in avoidance of cardiovascular events. Further studies are needed to provide more reliable information about the effectiveness of RBPM in preventing hypertensive cardiovascular complications.
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Choi et al. (2019) studied this question.
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