For people with high blood pressure, telemonitoring may cut heart
attack, stroke rate by 50%

Date:
August 31, 2020
Source:
American Heart Association
Summary:
Adults with uncontrolled high blood pressure were about half as
likely to have serious cardiovascular events in the five years
after a pharmacist- led telemonitoring program compared to those
receiving routine primary care. By reducing cardiovascular events,
the telemonitoring intervention saved about $1,900 over five years
in overall health care costs for each individual.



FULL STORY ========================================================================== People enrolled in a pharmacist-led telemonitoring program to control
high blood pressure were about half as likely to have a heart attack or
stroke compared to those who received routine primary care, according
to new research published today in Hypertension, an American Heart
Association journal.


========================================================================== Researchers, led by study author Karen L. Margolis, M.D., M.P.H.,
executive director of research at HealthPartners Institute in Minneapolis, Minn., found that a heart attack, stroke, stent placement or heart failure hospitalization occurred in 5.3% of the telemonitoring group vs. 10.4%
of the routine primary care group.

"Home blood pressure monitoring linked with treatment actions from the
health care team delivered remotely (telehealth support) in between office visits has been shown to lower blood pressure more than routine care, and patients really like it," said Margolis. "In addition, by avoiding serious cardiovascular events over 5 years, our results indicate significant
cost savings." Patients reported that they liked having support from a
trusted professional, rapid feedback and adjustments to their treatment,
and having someone to be accountable to.

Margolis reports that over 5 years, the savings from reduced
cardiovascular disease events exceeded the telemonitoring intervention
costs by $1,900 per patient.

"The findings were just short of statistical significance," said Margolis, "meaning they could have been due to chance. However, we were surprised
that the figures on serious cardiovascular events pointed so strongly
to a benefit of the telemonitoring intervention," she said.

Uncontrolled high blood pressure is the largest modifiable risk factor contributing to death from all causes. Nearly half of U.S. adults have
high blood pressure, defined as equal to or greater than 130 mm Hg
systolic (top number), or 80 mm Hg diastolic (bottom number). However,
most adults with high blood pressure don't have their numbers under
control.



==========================================================================
450 participants with uncontrolled high blood pressure were enrolled in
the study, conducted at 16 primary care clinics within the HealthPartners system in Minnesota. Participants were blinded and randomized to two
groups: 222 patients were in the routine primary care group, and 228
in the telemonitoring group that also received one year of remote care
managed by a pharmacist. In the telemonitoring group, patients were able
to measure their blood pressure at home and send it electronically to the pharmacist, who then worked with them to make medication and lifestyle
changes in their treatment.

In clinic visits for all participants, researchers monitored blood
pressure at enrollment, 6 months, 12 months, 18 months and 5 years;
kept track of any heart attacks, strokes, coronary stents, heart failure hospitalizations and heart- related deaths that occurred; and counted
all the costs of their blood pressure-related care and cardiovascular
event care.

They found: In the telemonitoring group, there were 15 serious
cardiovascular events (5 non-fatal heart attacks, 4 non-fatal strokes,
5 heart failure hospitalizations, 1 CV death) among 10 patients. This
group also had 2 stent placements, making the total event rate 5.3%.

In the routine primary care group, there were 26 serious cardiovascular
events (11 non-fatal heart attacks, 12 non-fatal strokes, 3 heart failure hospitalizations) among 19 patients. They also had 10 stent placements,
making the total event rate 10.4%.

Based on these findings, "widespread adoption of the telemonitoring
model might help U.S. adults with uncontrolled high blood pressure avoid serious cardiovascular events and reduce health care costs," according
to Margolis and colleagues. They recommend future studies to figure out
how to increase the number of patients engaged in home blood pressure monitoring over many years, and to measure cardiovascular risk factors
and cardiovascular events over that extended period.

The study's limitations are its relatively small size, and it was at a
single medical group's urban and suburban primary care clinics, which
may not represent the diversity of patients who receive care in other
settings across the country.


========================================================================== Story Source: Materials provided by American_Heart_Association. Note:
Content may be edited for style and length.


========================================================================== Journal Reference:
1. Karen L. Margolis, Steven P. Dehmer, JoAnn Sperl-Hillen, Patrick J.

O'Connor, Stephen E. Asche, Anna R. Bergdall, Beverly B. Green,
Rachel A.

Nyboer, Pamala A. Pawloski, Nicole K. Trower, Michael V. Maciosek.

Cardiovascular Events and Costs With Home Blood
Pressure Telemonitoring and Pharmacist Management for
Uncontrolled Hypertension. Hypertension, 2020; DOI:
10.1161/HYPERTENSIONAHA.120.15492 ==========================================================================

Link to news story: https://www.sciencedaily.com/releases/2020/08/200831112215.htm

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