Physician-led telemedical care reduced systolic blood pressure by 15.0 mmHg versus 4.0 mmHg with standard care, and increased total time in target range to 42.9% versus 24.8% at 6 months.
Does physician-led telemedical care improve time in target range for blood pressure in adults with uncontrolled hypertension?
Physician-led telemedical care with biweekly calls significantly improves blood pressure control and measurement adherence in patients with uncontrolled hypertension compared to standard care.
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Abstract Background Despite advances in antihypertensive therapy, blood pressure (BP) control remains inadequate in many patients due to limited follow-up and insufficient medication titration. Methods This single-centre, randomized controlled pilot trial was conducted at a tertiary academic hospital in Germany between 12/2023 to 09/2024. Sixty adults with uncontrolled hypertension (office BP 140/90mmHg despite antihypertensive medication) were randomized 1:1 to standard care or physician-led telemedical care. All participants performed home BP measurements twice daily using validated telemedical devices. The intervention group received structured biweekly calls for BP review and medication optimization. The control group continued care with their general practitioners. The primary endpoint was time in target range (TTR) over 6 months, defined as the percentage of home BP readings below guideline thresholds (130/80 mmHg for age 65, 140/90 mmHg for age ≥65). Group comparisons used t-tests. The study was registered at CinlicalTrials.gov Identifier NCT07049289. Results Fifty-six patients completed 6-month follow-up (mean age 61±13 years, 61% male). Baseline BP was 161±17/97±12 mmHg. At 6 months, systolic BP decreased by -15.0±9.8 mmHg in the intervention group vs. -4.0±8.7 mmHg in the control group (p0.001). Mean systolic TTR was significantly higher in the telemedical care group (52.2±24.2% vs. 36.0±29.2%, p=0.028), as was diastolic TTR (59.0±31.0% vs. 37.1±34.4 %, p=0.016), and total TTR (42.9±27.5% vs. 24.8±29.7%, p=0.021). Measurement adherence was superior in the intervention group (83.2±15.4% vs. 70.5±25.9%, p=0.033). Conclusion Physician-supported telemedical care significantly improved BP control and measurement adherence over 6 months. Larger trials are needed to assess long-term clinical outcomes.
Sagmeister et al. (Sat,) reported a other. Physician-led telemedical care reduced systolic blood pressure by 15.0 mmHg versus 4.0 mmHg with standard care, and increased total time in target range to 42.9% versus 24.8% at 6 months.