Home blood pressure telemonitoring improves hypertension control in general practice. The TeleBPCare study.
BACKGROUND
Self blood pressure monitoring at home may improve blood pressure control and patients' compliance with treatment, but its implementation in daily practice faces difficulties. Teletransmission facilities may offer a more efficient approach to long-term home blood pressure monitoring.


METHODS
Twelve general practitioners screened 391 consecutive uncontrolled mild-moderate hypertensive patients (80% treated), 329 of whom (58 +/- 11 years, 54% men) were randomized to either usual care on the basis of office blood pressure (group A, n = 113) or to integrated care on the basis of teletransmitted home blood pressure (group B, n = 216). Twenty-four-hour ambulatory blood pressure monitoring was performed at baseline and after 6 months, during which treatment was optimized according to either office (group A) or home (group B) blood pressure values. We compared differences between groups in the rate of daytime ambulatory blood pressure normalization (<130/80 mmHg), need of treatment changes during follow-up, quality of life scores, and healthcare costs.


RESULTS
Baseline office blood pressures were 149 +/- 12/89 +/- 9 and 148 +/- 13/89 +/- 7 mmHg in groups A (n = 111) and B (n = 187) respectively, the corresponding daytime values being 140 +/- 11/84 +/- 8 and 139 +/- 11/84 +/- 8 mmHg. The percentage of daytime blood pressure normalization was higher in group B (62%) than in group A (50%) (P < 0.05). There were less frequent treatment changes in group B than in group A (9 vs. 14%, P < 0.05). Quality of life tended to be higher and costs lower in group B.


CONCLUSIONS
Patients' management based on home blood pressure teletransmission led to a better control of ambulatory blood pressure than with usual care, with a more regular treatment regimen.
Parati
Gianfranco
G
Department of Cardiology, San Luca Hospital, Instituto Auxologico Italiano, Milan, Italy. gianfranco.parati@unimib.it
Omboni
Stefano
S
Albini
Fabio
F
Piantoni
Lucia
L
Giuliano
Andrea
A
Revera
Miriam
M
Illyes
Miklos
M
Mancia
Giuseppe
G
D000368:Aged; D018660:Blood Pressure Monitoring, Ambulatory; D005194:Family Practice; D005260:Female; D006801:Humans; D006973:Hypertension / Q000188:drug therapy* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D017216:Telemedicine