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Home blood pressure-lowering effect of digital therapeutics in hypertension: impact of body weight and salt intake

Hypertension Research volume 46, pages 1181–1187 (2023)Cite this article

Abstract

Lifestyle modifications, including body weight reduction and salt restriction, help reduce blood pressure (BP). This study investigated the effects of body mass index (BMI) and salt intake on home BP reductions in unmedicated patients with hypertension receiving guideline-based lifestyle modification from doctors (control group) or with the addition of a digital therapeutics intervention. Data from the HERB Digital Hypertension 1 (HERB-DH1) pivotal trial were analyzed. Home BP was measured for 7 days before each study visit (baseline, and 4/8/12 weeks). Body weight was measured at each visit and salt intake questionnaire was answered at baseline and 12 weeks. This analysis included 302 patients with sufficient home BP monitoring data (digital therapeutics: 156; control group: 146). The reduction in morning home SBP from baseline to 12 weeks was significantly greater in the digital therapeutics vs. control group for patients with baseline BMI ≥ 25 kg/m2 and higher salt intake group (self-reported salt intake score ≥ 14) (–5.1 mmHg, p < 0.01). Patients in the digital therapeutics group who experienced a reduction in BMI and an improvement in salt intake score during the 12-week study also had a significantly greater reduction in morning home SBP compared with patients in the control group (–7.2 mmHg, p < 0.01). The digital therapeutic intervention reduced home BP the most in unmedicated patients with hypertension with high baseline BMI and salt intake score. Those with improvements in both BMI and salt intake during the digital therapeutics intervention achieved the greatest reduction in home BP vs. control.

Clinical trial registration: Japan Registry of Clinical Trials (jRCT2032190148)

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Acknowledgements

English language editing assistance was provided by Nicola Ryan, independent medical writer, funded by Jichi Medical University.

Funding

Funding

The HERB DH1 study was funded by CureApp Inc. This work was supported by Japan Agency for Medical Research and Development (AMED) under Grant Number 22rea522105h0001.

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Authors and Affiliations

  1. Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine, Tochigi, Japan

    Kazuomi Kario, Naoko Tomitani, Noriko Harada, Ayako Okura & Satoshi Hoshide

  2. CureApp, Inc., Tokyo, Japan

    Fumi Hisaki & Tomoyuki Tanigawa

Authors
  1. Kazuomi Kario
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  2. Naoko Tomitani
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  3. Noriko Harada
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  4. Ayako Okura
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  5. Fumi Hisaki
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  6. Tomoyuki Tanigawa
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  7. Satoshi Hoshide
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Contributions

Study conception and design: KK, NT, NH, AO, FH, and TT. Data preparation: NH and FH. Data analysis and interpretation: KK, NT, and SH. Drafting and revising of the paper: KK, NT, and SH. Final approval of the submitted paper: KK.

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Correspondence to Kazuomi Kario.

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Conflict of interest

KK has received research grants from Cure App, A&D Co. and from Omron Healthcare. KK has received consulting fees from CureApp Inc. TT and FH are employees of CureApp Inc. All other authors have no competing interests to disclose.

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Kario, K., Tomitani, N., Harada, N. et al. Home blood pressure-lowering effect of digital therapeutics in hypertension: impact of body weight and salt intake. Hypertens Res 46, 1181–1187 (2023). https://doi.org/10.1038/s41440-023-01245-7

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