Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Review Article
  • Published:

Contribution of telemedicine and information technology to hypertension control

Hypertension Research volume 43, pages 621–628 (2020)Cite this article

Abstract

Due to fast-paced technological advancements, digital health and telemedicine represent a promising and complex reality, with the potential to change the current management of hypertension and improve its outcomes. New types of health-related strategies are available, ranging from telemonitoring of blood pressure (BP) values to counseling for patients and decisional tools for physicians, thanks to the development of new technology. Even though the strength of available evidence is currently low due to the high heterogeneity of studies and of the proposed interventions, available data suggest a beneficial effect of digital health strategies on BP control and, more generally, on cardiovascular risk reduction. In addition, well-designed randomized controlled trials are needed to further investigate the real impact of these new strategies on clinical outcomes. Furthermore, due to consistent commercial interests in this field, there is a strong need for strict regulations to ensure a safe and secure implementation of this new reality in clinical care.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Daugherty SL, Powers JD, Magid DJ, Tavel HM, Masoudi FA, Margolis KL, et al. Incidence and prognosis of resistant hypertension in hypertensive patients. Circulation. 2012;125:1635–42.

    Article  Google Scholar 

  2. GBD 2015 Risk Factors Collaborators. Global, regional, and national comparative risk assessment of 79 behavioural, environmental and occupational, and metabolic risks or clusters of risks, 1990-2015: a systematic analysis for the Global Burden of Disease Study 2015. Lancet. 2016;388:1659–724.

    Article  Google Scholar 

  3. Williams B, Mancia G, Spiering W, Agabiti-Rosei E, Azizi M, Burnier M, et al. 2018 ESC/ESH guidelines for the management of arterial hypertension. Eur Heart J. 2018;39:3021–104.

    Article  Google Scholar 

  4. Gupta P, Patel P, Štrauch B, Lai FY, Akbarov A, Gulsin GS, et al. Biochemical screening for nonadherence is associated with blood pressure reduction and improvement in adherence. Hypertension. 2017;70:1042–8.

    Article  CAS  Google Scholar 

  5. Omboni S, Gazzola T, Carabelli G, Parati G. Clinical usefulness and cost effectiveness of home blood pressure telemonitoring. J Hypertens. 2013;31:455–68.

    Article  CAS  Google Scholar 

  6. Parati G, Stergiou GS, Asmar R, Bilo G, de Leeuw P, Imai Y, et al. European Society of Hypertension practice guidelines for home blood pressure monitoring. J Hum Hypertens. 2010;24:779–85.

    Article  CAS  Google Scholar 

  7. Duan Y, Xie Z, Dong F, Wu Z, Lin Z, Sun N, et al. Effectiveness of home blood pressure telemonitoring: a systematic review and meta-analysis of randomised controlled studies. J Hum Hypertens. 2017;31:427–37.

    Article  CAS  Google Scholar 

  8. Tucker KL, Sheppard JP, Stevens R, Bosworth HB, Bove A, Bray EP, et al. Self-monitoring of blood pressure in hypertension: a systematic review and individual patient data meta-analysis. PLoS Med. 2017;14:e1002389.

    Article  Google Scholar 

  9. Hanley J, Pinnock H, Paterson M, McKinstry B. Implementing telemonitoring in primary care: learning from a large qualitative dataset gathered during a series of studies. BMC Fam Pract. 2018;19:118.

    Article  Google Scholar 

  10. McManus RJ, Mant J, Franssen M, Nickless A, Schwartz C, Hodgkinson J, et al. Efficacy of self-monitored blood pressure, with or without telemonitoring, for titration of antihypertensive medication (TASMINH4): an unmasked randomised controlled trial. Lancet. 2018;391:949–59.

    Article  Google Scholar 

  11. Monahan M, Jowett S, Nickless A, Franssen M, Grant S, Greenfield S, et al. Cost-effectiveness of telemonitoring and self-monitoring of blood pressure for antihypertensive titration in primary care (Tasminh4). Hypertension. 2019;73:1231–9.

    Article  CAS  Google Scholar 

  12. Asch DA, Muller RW, Volpp KG. Automated hovering in health care–watching over the 5000h. N Engl J Med. 2012;367:1–3.

    Article  CAS  Google Scholar 

  13. de Jongh T, Gurol-Urganci I, Vodopivec-Jamsek V, Car J, Atun R. Mobile phone messaging for facilitating self-management of long-term illnesses. Cochrane Database Syst Rev. 2012;12:CD007459.

    PubMed  Google Scholar 

  14. Michard F. A sneak peek into digital innovations and wearable sensors for cardiac monitoring. J Clin Monit Comput. 2017;31:253–9.

    Article  Google Scholar 

  15. Goldberg EM, Levy PD. New approaches to evaluating and monitoring blood pressure. Curr Hypertens Rep. 2016;18:49.

    Article  Google Scholar 

  16. mHealth: use of mobile wireless technologies for public health. Report by the WHO Secretariat. 2016. EB139/8. http://apps.who.int/gb/ebwha/pdf_files/EB139/B139_8-en.pdf?ua=1. Last access 4 Mar 2020.

  17. Burke LE, Ma J, Azar KMJ, Bennett GG, Peterson ED, Zheng Y, et al. Current science on consumer use of mobile health for cardiovascular disease prevention. Circulation. 2015;132:1157–213.

    Article  Google Scholar 

  18. Liu S, Dunford SD, Leung YW, Brooks D, Thomas SG, Eysenbach G, et al. Reducing blood pressure with Internet-based interventions: a meta-analysis. Can J Cardiol. 2013;29:613–21.

    Article  CAS  Google Scholar 

  19. Uhlig K, Patel K, Ip S, Kitsios GD, Balk EM. Self-measured blood pressure monitoring in the management of hypertension: a systematic review and meta-analysis. Ann Intern Med. 2013;159:185–94.

    Article  Google Scholar 

  20. Bloss CS, Wineinger NE, Peters M, Boeldt DL, Ariniello L, Kim JY, et al. A prospective randomized trial examining health care utilization in individuals using multiple smartphone-enabled biosensors. PeerJ. 2016;4:e1554.

    Article  Google Scholar 

  21. Lu X, Yang H, Xia X, Lu X, Lin J, Liu F, et al. Interactive mobile health intervention and blood pressure management in adults: a meta-analysis of randomized controlled trials. Hypertension. 2019;74:697–704.

    Article  CAS  Google Scholar 

  22. van den Heuvel JFM, Kariman SS, van Solinge WW, Franx A, Lely AT, Bekker MN. SAFE@HOME—feasibility study of a telemonitoring platform combining blood pressure and preeclampsia symptoms in pregnancy care. Eur J Obstet Gynecol Reprod Biol. 2019;240:226–31.

    Article  Google Scholar 

  23. Turakhia M, Perez M, Desai M. Results of a large-scale, app-based study to identify atrial fibrillation using a smartwatch: the Apple Heart Study. Presented at the 68th American College of Cardiology Scientific Session, New Orleans, Louisiana, 16–18 March 2019. Abstract 19-LB-20253.

  24. Guo Y, Wang H, Zhang H, Liu T, Liang Z, Xia Y, et al. Mobile photoplethysmographic technology to detect atrial fibrillation. J Am Coll Cardiol. 2019;74:2365–75.

    Article  Google Scholar 

  25. Parati G, Torlasco C, Omboni S, Pellegrini D. Smartphone applications for hypertension management: a potential game-changer that needs more control. Curr Hypertens Rep. 2017;19:48.

    Article  Google Scholar 

  26. Policy for Device Software Functions and Mobile Medical Applications Guidance for Industry and Food and Drug Administration Staff. 2019. https://www.fda.gov/media/80958/download. Last access 9 Mar 2020.

  27. Kumar N, Khunger M, Gupta A, Garg N. A content analysis of smartphone-based applications for hypertension management. J Am Soc Hypertens. 2015;9:130–6.

    Article  Google Scholar 

  28. Albini F, Xiaoqiu L, Torlasco C, Soranna D, Faini A, Ciminaghi R, et al. An ICT and mobile health integrated approach to optimize patients’ education on hypertension and its management by physicians: the patients optimal strategy of treatment (POST) pilot study. Conf Proc IEEE Eng Med Biol Soc. 2016;2016:517–20.

    PubMed  Google Scholar 

  29. Parker RA, Paterson M, Padfield P, Pinnock H, Hanley J, Hammersley VS, et al. Are self-reported telemonitored blood pressure readings affected by end-digit preference: a prospective cohort study in Scotland. BMJ Open. 2018;8:e019431.

    Article  Google Scholar 

  30. Parati G, Dolan E, McManus RJ, Omboni S. Home blood pressure telemonitoring in the 21st century. J Clin Hypertens. 2018;20:1128–32.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Istituto Auxologico Italiano, IRCCS, Department of Cardiovascular Neural and Metabolic Sciences, S. Luca Hospital, Milan, Italy

    Dario Pellegrini, Camilla Torlasco, Juan Eugenio Ochoa & Gianfranco Parati

  2. Department of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy

    Dario Pellegrini, Camilla Torlasco & Gianfranco Parati

Authors
  1. Dario Pellegrini
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Camilla Torlasco
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Juan Eugenio Ochoa
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Gianfranco Parati
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Gianfranco Parati.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Additional information

Publisher’s note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Pellegrini, D., Torlasco, C., Ochoa, J.E. et al. Contribution of telemedicine and information technology to hypertension control. Hypertens Res 43, 621–628 (2020). https://doi.org/10.1038/s41440-020-0422-4

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/s41440-020-0422-4

Keywords

This article is cited by

Search

Advanced search

Quick links