Structured telemonitoring with biweekly telephone consultations significantly increased the overall time in target blood pressure range compared to standard care (43% vs. 25%, p=0.023).
RCT (n=60)
Randomized
No
Does a structured telemonitoring program with biweekly telephone consultations improve blood pressure control in patients with uncontrolled arterial hypertension?
A structured telemonitoring program with biweekly telephone consultations significantly improved blood pressure control and time in target range in patients with uncontrolled hypertension.
Absolute Event Rate: 43% vs 25%
p-value: p=0.023
Abstract Background Despite advances in antihypertensive therapy, many patients with arterial hypertension remain uncontrolled, often due to insufficient monitoring and follow-up in ambulatory settings. This single-centre, randomized controlled trial aimed to assess whether a structured telemonitoring program combined with regular telephone consultations could improve blood pressure (BP) control compared to the current standard of care. Methods Sixty patients with uncontrolled arterial hypertension were randomized into two groups. The control group performed two BP measurements twice daily, which were automatically transmitted via telemonitoring. They received no additional contact with the study team and were treated by their general physician. The intervention group also performed BP measurements twice daily but received biweekly telephone calls for medication adjustments and prescription renewals as needed. Both groups had in-hospital visits at 6 and 12 months, with a crossover after the first six months. The primary endpoint was the percentage of time in the target BP range during the first six months, defined as 130/80 mmHg for patients under 65 years and 140/90 mmHg for patients 65 years or older. Results Participants had a mean age of 61±13 years, were predominantly male (61%) and primarily Caucasian (98%). Baseline BP was elevated (systolic BP 161±18 mmHg, diastolic BP 97±12 mmHg), with comparable characteristics between groups. At 6 months, the intervention group achieved a significantly greater reduction in systolic BP (-14.8±9.7 vs. -4.1±8.7 mmHg, p0.001) and diastolic BP (-9.8±6.6 vs. -1.8±5.6 mmHg, p0.001) compared to the control group. Time in target range for systolic (52±24 vs. 36±29%, p=0.027), diastolic (59±31 vs. 37±35%, p=0.017), as well as overall BP (43±28 vs. 25±30%, p=0.023) was significantly higher in the intervention group. Compliance with BP measurements was also better in the intervention group (83±15 vs. 71±26%, p=0.035). Conclusion This positive pilot trial indicates that structured telemonitoring with regular telephone follow-ups and medication adjustments can improve BP control. Larger, multicentre trials are planned to confirm these findings with respect to harder clinical endpoints.
Sagmeister et al. (Sat,) conducted a rct in Uncontrolled arterial hypertension (n=60). Structured telemonitoring with biweekly telephone consultations vs. Telemonitoring alone (standard of care) was evaluated on Percentage of time in the target BP range during the first six months (p=0.023). Structured telemonitoring with biweekly telephone consultations significantly increased the overall time in target blood pressure range compared to standard care (43% vs. 25%, p=0.023).