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Short-term telemedical home blood pressure monitoring does not improve blood pressure in uncomplicated hypertensive patients

Journal of Human Hypertension volume 31, pages 93–98 (2017)Cite this article

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Abstract

Telemonitoring of home blood pressure measurements (TBPM) is a new and promising supplement to diagnosis, control and treatment of hypertension. We wanted to compare the outcome of antihypertensive treatment based on TBPM and conventional monitoring of blood pressure. Participants were recruited from a prevalence study among citizens aged 55–64 years in the municipality of Holstebro, Denmark. The study was a randomized, controlled, unblinded 3 months’ trial. In the intervention group, antihypertensive treatment was based on TBPM with transmission of the measurements and subsequent communication by telephone or e-mail. In the control group, patients received usual care. Primary outcome was reduction in daytime ambulatory blood pressure measurements (ABPM) from baseline to 3 months’ follow-up. Of 375 participants randomized, primary outcome data were available for 356 (95%). In both groups, daytime ABPM decreased significantly. The decrease in daytime ABPM in the intervention group was systolic/diastolic, −8±12/−4±7 mm Hg. This did not differ significantly from the control group’s −8±13/−4±8 mm Hg. An equal number of participants obtained normal daytime ABPM, in the intervention group 17% (31/175) versus control 21% (37/181), P=0.34. We found that both TBPM patients and controls achieved a significant blood pressure reduction in this randomized, controlled, unblinded 3-month trial. We found no difference in blood pressure reduction or number of patients reaching blood pressure goals. Further information and education of some general practitioners seem to be relevant regarding blood pressure management and control of hypertension.

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Acknowledgements

We thank participating citizens and the general practitioners Ulla and Jakob Hoffmann-Petersen; Helle Bondesen and Jacob Houe; Marianne and Bent Conrad Pedersen; Susanne Schovsbo; Jørgen Buch, Dorte Navntoft and Ole Mecklenborg; Mette Damgaard and Lotte Jakobsen; Poul Erik Hven; Kirstine Albrectsen, Karen Schou and Pernille Tørring; Michael Poulsen, Agathe Mierzwinska and Niels Christian Bentsen; Annette Fleng and Jes Sørensen; Peder Kirkegaard; Anne Kristensen, Lene Kristensen, Tove Holm, Claus Larsen and Kurt Ebbensgaard; Tina Høst and Finn Olsen; Trine Overgaard and Anders Nissen; Ken Hermansen; Christian Thomsen; Laila Andersen, Poul Bøge, Rita Christiansen, Allan Raft, Audun Bosnes and Tina Lundorff. We thank study nurses Karen Markussen, Inge Winther and Mona Godtkjær, and laboratory technicians Susan Milton Rasmussen, Lisbeth Mikkelsen, Anne Mette Ravn, Kirsten Nygaard and Henriette Simonsen for skilful assistance. We thank Janni Maigaard Jensen MD, PhD for helpful assistance during the recruitment. We thank Ellen Greve and Jesper Ejstrup from the municipal preventive care centre for enthusiastic support. ClinicalTrials.gov identification number is NCT02531347. The study was funded by the Tryg Foundation, Municipality of Holstebro, Central Denmark Region and Research Fund of Central Denmark Region.

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Authors and Affiliations

  1. Department of Medical Research and Medicine, University Clinic of Nephrology and Hypertension, Holstebro Hospital and Aarhus University, Holstebro, Denmark

    N Hoffmann-Petersen, J N Bech & E B Pedersen

  2. Department of Public Health, Section of General Practice, Aarhus University, Aarhus, Denmark

    T Lauritzen

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  1. N Hoffmann-Petersen
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Correspondence to N Hoffmann-Petersen.

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Hoffmann-Petersen, N., Lauritzen, T., Bech, J. et al. Short-term telemedical home blood pressure monitoring does not improve blood pressure in uncomplicated hypertensive patients. J Hum Hypertens 31, 93–98 (2017). https://doi.org/10.1038/jhh.2016.43

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