Aspects of remote blood pressure monitoring in follow-up care organization for very high cardiovascular risk patients

Using of automated remote monitoring systems is considered as a way to improve the treatment outcomes for patients with high and very high cardiovascular risk (CVR) and arterial hypertension in the frames of regular follow-up monitoring.

The aim: to study the efficacy of remote blood pressure monitoring (RBPM) in organization of regular follow-up monitoring among working-age patients having very high CVR.

Material and methods. A single-center prospective observational study included working-age and older residents (18–75 years) of Primorsky Region with very high CVR. When analyzing RBPM results after 12 weeks of follow-up, target BP values were defined as mean values less than 140 and 70 mmHg. Patients who achieved and did not achieve target BP were compared according to various biochemical parameters.

Results. Initially the study included 150 patients with stage III arterial hypertension; 78 (52%) of them completed the study. 55 (70.5%) participants achieved mean BP values in the target range of 120–130/70–79 mmHg, of which 12 individuals had a tendency toward systolic arterial hypotension without statistical significance (121 [114–129] mmHg at baseline versus 109 [107–116] mmHg after 12 weeks, p = 0.72). In 23 (29.4%) patients, mean BP was outside the target range (121 [114–129] versus 142 [134–146.5] mmHg, p = 0.034). According to our data, a group of patients with a more unfavorable cardiometabolic risk profile, including reduced glomerular filtration rate, require more intensive outpatient BP monitoring and, if necessary, adjustment of the antihypertensive therapy and associated risk factors.

Conclusion. The aspect of use of RBPM as a part of the follow-up care of patients with high and very high CVR arterial hypertension in real-world clinical practice requires to be further studied, including a multicenter national study, to determine the balance between the maximum effect of follow-up care and cost-effectiveness.