Effects of home telemonitoring and community-based monitoring on blood pressure control in urban African Americans: a pilot study.
BACKGROUND
African Americans have a higher prevalence and greater severity of hypertension than do other minorities and whites. This fact is particularly problematic when one realizes that the rate of control and treatment of hypertension in the US population is getting worse rather than better. Alternative strategies to promote blood pressure control need to be tested.


OBJECTIVE
The purpose of this pilot study was to test the following hypothesis: Persons who participate in nurse-managed home telemonitoring (HT) plus usual care or who participate in nurse-managed community-based monitoring (CBM) plus usual care will have greater improvement in blood pressure from baseline to 3 months' follow-up than will persons who receive usual care only.


METHODS
This study used a randomized controlled design; participants were randomly assigned to 1 of 3 groups that were stratified by use or nonuse of antihypertension medication. One-way analysis of variance (ANOVA) and analysis of covariance (ANCOVA) controlling for age and body weight were used to determine changes in blood pressure from baseline to 3 months. The sample contained 26 African Americans with a mean age of 59 years.


RESULTS
Both the HT group and the CBM group had clinically and statistically significant (P <.05) drops in systolic blood pressure (SBP) and diastolic blood pressure (DBP) at 3 months' follow-up, with participants in the HT group demonstrating the greatest improvement (HT: baseline SBP 148.8 +/- 13.8, DBP 90.2 +/- 5.79; 3 months' follow-up SBP 124.1 +/- 13.82, DBP 75.58 +/- 11.4; CBM: baseline SBP 155.25 +/- 17.014, DBP 89.42 +/- 10.95; 3 months' follow-up SBP 142.3 +/- 12.1, DBP 78.25 +/- 6.86). There was little change in SBP or DBP at 3 months' follow-up in the usual care only group.


CONCLUSIONS
These are important pilot results, which if replicated in a larger sample will significantly improve care for urban African Americans with hypertension.
Artinian
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College of Nursing at Wayne State University, Detroit, Michigan 48202, USA.
Washington
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Templin
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D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000959:Antihypertensive Agents / Q000627:therapeutic use; D044383:Black People; D018660:Blood Pressure Monitoring, Ambulatory; D003153:Community Health Services / Q000706:statistics & numerical data*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006973:Hypertension / Q000208:ethnology* / Q000517:prevention & control*; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance; D010865:Pilot Projects; D017216:Telemedicine / Q000379:methods; D014504:Urban Health; D001741:Black or African American
D000959:Antihypertensive Agents