Remote Patient Monitoring Led to Reductions in Blood Pressure

A Mass General Brigham study published in JAMA Network Open described how a remote patient monitoring (RPM) tool showed the ability to treat high blood pressure among diverse populations, ultimately lessening the risk of cardiovascular disease and the need for in-person care.

According to the Centers for Disease Control and Prevention (CDC), over 670,000 deaths in the United States in 2020 involved hypertension (high blood pressure). The CDC also noted that 47 percent of US adults have hypertension and that the prevalence of the condition can vary based on demographics.

However, as the use of technology in healthcare continues to grow, researchers and physicians find ways to use devices to treat patients remotely.

To determine the relationship between RPM tools and hypertension, Benjamin Scirica, MD, a Mass General Brigham cardiologist who cares for patients at Brigham and Women’s Hospital, and the Accelerator for Clinical Transformation/Remote Heath team conducted a research effort.

“Our goal is to improve access and help patients achieve their health goals through developing entirely remote, or virtual, clinics. We know how hard it can be to come in for clinic visits and want to lower the barrier to receiving optimal care,” said Benjamin Scirica, MD, in a press release.

Following a screening process that took place between January 2018 and July 2021, researchers defined 10,803 patients to enroll in a comprehensive remote hypertension and cholesterol program. Of this population, 3,658 took part in the program to manage hypertension, 8,103 in the program to manage cholesterol, and 958 patients in both.

The program also contained a group of advanced practice pharmacists who prescribed patients medications.

“The pharmacists practiced under what are called collaborative drug treatment management agreements, which gives them prescribing ability as long as they’re following a medication algorithm designed by our clinicians,” said Scirica, in a press release. 

All patients received educational materials along with blood pressure cuffs;, however, 1,266 patients asked for only education without medication titration.

Of the total population, the mean age was 65, 56 percent were female, 12 percent identified as Black, 11 as Hispanic, 72 percent as White, and 16 percent as either another or multiple races.

Given that non-White patients are usually at a higher risk for high blood pressure and cholesterol, researchers tried to include a diverse population.

In total, researchers collected 424,482 blood pressure readings and 139,263 laboratory reports. Before the start of the study, the mean office blood pressure was 150/83 and the mean home blood pressure was 145/83 among patients in the hypertension program.

However, after analyzing the findings of the study, the team found that the program led to decreases in blood pressure and cholesterol, and they also found that success rates did not vary across demographics. Contrarily, those who engaged in only education did not experience gradual changes.

Previous efforts have also aimed to treat patients with hypertension and heart failure through RPM.

In September 2022, Watertown Regional Medical Center (WRMC) in Wisconsin created an RPM program to treat these conditions.

Through a partnership with Cadence, this RPM program contained cellular-enabled devices such as blood pressure monitors and weight scales, allowing patients to track health metrics and provide care teams with this information.

Although this program initially intended to treat only hypertension and heart failure, WRMC noted plans to treat diabetes and chronic obstructive pulmonary disease (COPD).