Effective BP Reduction Achieved via Hypertension Remote Care Program During Lockdown

Patients diagnosed with hypertension enrolled in a remote care management program reached and maintained target blood pressure (BP) goals during the COVID-19 pandemic, according to results of a study conducted at the Brigham and Women's Hospital (BWH) in Boston, MA.

Full findings are being presented during the American Heart Association (AHA) Scientific Sessions 2021 which will be held remotely November 13-15, 2021.

The deferral of nearly all routine chronic disease monitoring and management at the start of the COVID-19 lockdown in March 2020 offered a unique opportunity to BWH clinicians to evaluate the ability of an existing remote hypertension management program to deliver uninterrupted care.

The program combines automatic transmission of BP readings taken at home with intervention by a team of trained navigators who follow "expert-designed" medication titration algorithms. The researchers, led by Alexander Blood, MD, clinical fellow in cardiovascular medicine and clinical care at BWH, collected data from all patients enrolled in the remote monitoring program during the first 6 months of the declared health emergency in Boston (3/15/2020 to 9/15/2020) with a plan to assess management outcomes at an established cutoff of 1 year into the pandemic, ie, 3/15/2021.

Blood and his team also evaluated health care utilization by analyzing monthly visits to primary and non-primary care and BP readings measured during the year before enrollment in the remote care program compared to the same data points during the study year 3/15/2020 to 3/15/2021.

During the first week of pandemic lockdown, authors report that 651 patients were enrolled in the program and transmitted a home baseline BP. Based on those readings, they state in the study abstract, 475 patients (73%) were identified as having sustained hypertension.

Primary care visits decreased by 50% during this period and non-primary care visits fell by 40% (p>.001 for both).

The weekly mean BP transmitted at program baseline was 145/84 ±15/9 mm Hg which fell to 135/79 ± 15/10 mm Hg by program end (p<.001), according to the abstract.

All follow-up was completed by 240 participants whose average maintenance BP was 125/73 ± 7/7 mmHg (p<.001).

BP control, investigators say, was achieved with a mean of 2.3 medication titrations over the study period. During their time in the program, patients received an average of 8.2 phone calls each month and recorded a mean 32.4 individual BP measurements.

Blood et al conclude that an established remote health delivery program succeeded in delivering uninterrupted, effective care to help patients with hypertension reduce BP and reach clinical targets during a period when in-person clinical care decreased dramatically. "Further study is warranted to understand the role remote care can play in hypertension management as we exit the pandemic," they state.

The abstract will be presented during the Abstract Poster Session titled Hot Science in Hypertension and Kidney Disease on Saturday, November 13, 2021, between 11:00 am and 12 noon, EST.

Reference: Blood AJ, Chaney K, Zelle D, et al. Remote hypertension management during the COVID-19 pandemic. Abstract presented at the American Heart Association Scientific Sessions 2021, held virtually November 13-15, 2021.