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Home monitoring and telemedicine shows promise in lowering blood pressure, finds SUNY Upstate study

Patients who monitored their blood pressure from home with automatic transmission of this information to their doctors were able to lower their blood pressure while those who were treated for hypertension under usual care saw their blood pressure worsen, according to a study by researchers at the State University of New York Upstate Medical University.

The study, published in the June 5 issue of the Annals of Internal Medicine, suggests the use of telecommunication systems in assessing and improving blood pressure in patients with hypertension may be worthwhile.

"The routine monitoring of blood pressure levels and the automatic dissemination of the information to the physicians in a timely manner enabled these patients to have their condition evaluated regularly by a physician," said the study's lead author, Mary A. M. Rogers, Ph.D., associate professor of epidemiology at Upstate Medical University. "When physicians saw elevated blood pressure readings, they were able to call patients to make adjustments to medications or arrange an office visit."

In patients who received home care service, the mean systolic blood pressure decreased by 4.9 mm Hg while the mean diastolic blood pressure dropped by 2.0 mm Hg. Patients who received usual care noted a decrease of 0.1 mm Hg in the mean systolic blood pressure, but an increase of 2.1 mm Hg in mean diastolic blood pressure.

The change in blood pressure readings was particularly significant in African American patients. For those receiving home care average arterial blood pressure decrease by 9.6 mm Hg, while average arterial blood pressure increase by 5.25 mm Hg in those receiving usual care.

Patients in the randomized control trial who used the home monitoring service took three blood pressure readings in the mornings and evenings at least three times a week during the trial. Reports detailing blood pressure and heart rate information were transmitted electronically each week to physicians and patients. Patients in the study group being treated under usual care had their blood pressure monitored according to the National Institutes of Health guidelines for hypertension treatment which indicate that patients be seen by their physician within in one to two months after medication adjustment.

"Accurate and timely information provides an essential cornerstone for the provision of quality medical care," Rogers said. "It is important that technological advances that assist the physician in obtaining this information be tested