Self-management of blood pressure via telemonitoring by patients with hypertension actually can produce better results than conventional, episodic care by health professionals, a new study indicates. The study, conducted at 24 general practices in the UK and reported this month in The Lancet, claims to be the first to test both telemonitoring and self-adjustment of hypertension medications together, and the first to examine self-adjustment on a wide scale.
About half of the 527 participants were given blood-pressure monitors connected to automated modems, and asked to test their own blood pressure each morning. Lights on the device indicated whether the patient's BP was below a pre-determined target and/or within a safety limit. Patients were trained to adjust their medications based on a physician's recommendation, and were able to track progress over the Internet.
After 12 months, those in the self-management group saw mean systolic blood pressure fall by 17.6 mm of mercury, while those who received traditional care only experienced a mean drop of 12.2 mm, and most patients in the test group took action in response to abnormal readings even before receiving telephone reminders.
"This study shows that self-management of hypertension, consisting of regular self-measurements of blood pressure and a simple predetermined titration plan for antihypertensive drugs, is more effective in lowering systolic blood pressure than is usual care during one year," the researchers write. The lower blood pressure, they say, reduced the risk of stroke for patients by at least 20 percent and heart disease by more than 10 percent.