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Effectiveness of home blood pressure telemonitoring: a systematic review and meta-analysis of randomised controlled studies

Journal of Human Hypertension volume 31, pages 427–437 (2017)Cite this article

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Abstract

To summarise evidence about the effectiveness of home blood pressure telemonitoring (HBPT) and identify the key components of intervention. We comprehensively searched PubMed, EMBASE and the Cochrane Library for relevant studies. The authors were contacted for additional information. Two authors independently extracted the data and assessed the risk of bias. 46 randomised controlled trials including a total of 13 875 cases were identified. Compared with usual care, HBPT improved office systolic blood pressure (BP) and diastolic BP by 3.99 mm Hg (95% confidence interval (CI): 5.06–2.93; P<0.001) and 1.99 mm Hg (95% CI: −2.60 to −1.39; P<0.001), respectively. A larger proportion of patients achieved BP normalisation in the intervention group (relative risk (RR): 1.16; 95% CI: 1.08–1.25; P<0.001). For HBPT plus additional support (including counselling, education, behavioural management, medication management with decision, adherence contracts and so on) versus HBPT alone (or plus less intense additional support), the mean changes in systolic and diastolic BP were 2.44 mm Hg (95% Cl, 4.88 to 0.00 mm Hg; P=0.05) and 1.12 mm Hg (95% CI, −2.34 to 0.1 mm Hg; P=0.07), respectively. For those surrogate outcomes, low-strength evidence failed to show difference. In subgroup analysis, high strength evidence supported a lower BP with HBPT that lasted for 6 or 12 months and was accompanied with counselling support from study personnel. HBPT can improve BP control in the hypertensive patients. It may be more efficacious when a proactive additional support is provided during the intervention process.

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Acknowledgements

The study was funded by grants from Municipal Science Foundation Grants of Guangzhou, China (2013Y2-00130) and Health Collaborative Innovation Major projects of Guangzhou, China (201508020253).

Author contributions

Zhiquan Xie had full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis. Study concept and design by Xie and Duan. Acquisition of data by Sun and Xu. Selection and Statistical analysis of data by Duan and Lin. Quality assessment by Dong and Wu. Arbitrators by Xie and Wu. Drafting of the manuscript by Duan and Xie. Administrative, technical or material support by Xie and Duan. Supervision by Xie.

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Authors and Affiliations

  1. First Clinical Medical College, Southern Medical University, Guangzhou, China

    Y Duan & Z Xie

  2. The Geriatric Cardiovascular Ward, General Hospital of Guangzhou Military Command of the People’s Liberation Army, Guangzhou, China

    Y Duan, Z Xie, F Dong, Z Wu, Z Lin, N Sun & J Xu

  3. Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China

    N Sun

  4. Clinical Medical College, Guangdong Pharmaceutical University, Guangzhou, China

    J Xu

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Correspondence to Z Xie.

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Duan, Y., Xie, Z., Dong, F. et al. Effectiveness of home blood pressure telemonitoring: a systematic review and meta-analysis of randomised controlled studies. J Hum Hypertens 31, 427–437 (2017). https://doi.org/10.1038/jhh.2016.99

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