[Usefulness of a telematic system and image analysis in the follow-up of high-risk patients: a new health service model].
BACKGROUND
Inadequate blood pressure control in hypertensive patients is in contrast with the evidence from clinical studies of effectiveness of the same antihypertensive compounds used in clinical practice. These results may be due to follow-up management of hypertensive patients and in particular to the interaction between general practitioners (GPs) and hypertension specialists. The aim of this study was to assess the effectiveness of an internet-based digital network, connecting specialists and GPs in the Campania Region, on blood pressure control and major cardiovascular events.


METHODS
A network between the Hypertension Center of "Federico II" University, 14 specialist centers and 60 GPs was done in the Campania Region (Campania Salute Project, CS). Randomized GPs enrolled in CS could update online clinic records of patients (n = 1979). As a control group, we included 2045 patients referred to the specialist centers by GPs from outside the network. All patients completed a 2-year follow-up.


RESULTS
CS determined a significant reduction in systolic and diastolic blood pressure (CS group 144 +/- 18/91 +/- 11 vs 136 +/- 17/86 +/- 10 mmHg; control group 144 +/- 17/90 +/- 10 vs 139 +/- 15/87 +/- 9 mmHg, p < 0.001). Indeed, the CS group showed less frequent fatal and non-fatal major cardiovascular events (2.9 vs 4.3%, chi2 = 5.047, p < 0.02).


CONCLUSIONS
Our results support the hypothesis that telematic connections may contribute to improve blood pressure control and reduce major cardiovascular events.
De Luca
Nicola
N
Dipartimento di Medicina Clinica e Scienze Cardiovascolari, Università degli Studi "Federico II", Napoli. nideluca@unina.it
Izzo
Raffaele
R
Rozza
Francesco
F
Iovino
Gianni Luigi
GL
Rao
Maria Assunta Elena
MA
Arcucci
Oreste
O
Di Marino
Serena
S
Vasta
Antonio
A
Lardo
Lucia
L
Ceccarelli
Michele
M
Trimarco
Bruno
B
D000328:Adult; D000704:Analysis of Variance; D001795:Blood Pressure Determination; D002318:Cardiovascular Diseases / Q000175:diagnosis / Q000517:prevention & control; D016022:Case-Control Studies; D005260:Female; D005500:Follow-Up Studies; D006296:Health Services; D006801:Humans; D006973:Hypertension / Q000175:diagnosis*; D020407:Internet; D007558:Italy; D016015:Logistic Models; D008297:Male; D008511:Medicine / Q000706:statistics & numerical data; D008875:Middle Aged; D016017:Odds Ratio; D010821:Physicians, Family / Q000706:statistics & numerical data; D012189:Retrospective Studies; D012307:Risk Factors; D013038:Specialization; D018709:Statistics, Nonparametric; D017216:Telemedicine