Hypertension: Home-based care may be the future
Blood pressure is the force of blood pushing against the artery walls.
Blood pressure rises and falls throughout the day, but it can be harmful if it stays high for a long time.
High blood pressure, or hypertension, increases a person’s risk of dangerous health conditions, such as heart attack, stroke, chronic heart failure, and kidney disease.
According to the Centers for Disease Control and Prevention (CDC), about 75 million adults in the United States have high blood pressure.
In 2014, high blood pressure was a primary or contributing cause of death for more than 410,000 people in the U.S. Despite the dangers of this health condition, only about half of the people living with hypertension have their blood pressure under control.
A new approach to hypertension control
Researchers at Brigham and Women’s Hospital in Boston, MA developed a home-based program to improve hypertension control rates at a lower cost than traditional office-based programs. The results feature in the journal Clinical Cardiology.
The team of researchers enrolled 130 people into the program, whom they recruited from a Brigham primary care clinic and the Brigham’s Watkins Cardiovascular Clinic. At the time of recruitment, the participants’ blood pressure was not under control.
The researchers taught the participants how to use a Bluetooth-enabled blood pressure device and instructed them to measure their blood pressure at home twice daily in duplicate.
The program helped 81 percent of the participants bring their blood pressure under control in less than 2 months.
“This is a striking result, especially given the very short time frame in which control was reached: an average of 7 weeks,” says Dr. Naomi Fisher, director of Hypertension Services and the Hypertension Specialty Clinic at the Brigham.
How does it work?
Researchers combined several innovative strategies to create the program. Firstly, the Bluetooth-enabled blood pressure device automatically transmitted the measurements into the electronic medical records of the participants.
Each individual also had access to nonphysician “patient navigators” who had received training in how to use specially designed clinical algorithms. Specialists developed these algorithms, which help assess the person and ensure that they are receiving the correct dosage of medication.
“The time-honored model of treating hypertension via traditional visits to the doctor is neither effective nor sustainable.”
Author Dr. Naomi Fisher
Although this pilot study produced excellent results, the team hopes to be able to scale up the program in the near future to make sure that the method will continue to work over a more extended period and that it can be effective in other groups of people.
The researchers estimate that this new approach will significantly reduce the costs of hypertension control and prevent the risk of dangerous health conditions relating to high blood pressure.
“Development of innovative solutions to manage hypertension effectively and efficiently, and thus reduce the cardiovascular risk burden in larger populations, is critical. Organizations can and should develop and adopt innovative technologies to create sustainable solutions for the control of hypertension,” concludes Fisher.
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