Effect of Home Blood Pressure Telemonitoring Plus Additional Support on Blood Pressure Control: A Randomized Clinical Trial

Objective Current clinical evidence on the effects of home blood pressure telemonitoring(HBPT) on improving blood pressure control comes entirely from developed countries. Thus, we performed this randomized controlled trial to evaluate whether HBPT plus support(patient education and clinician remote hypertension management) improves blood pressure control more than usual care(UC) in the Chinese population.Methods This single-center, randomized controlled study was conducted in Beijing, China. Patients aged 30–75 years were eligible for enrolment if they had blood pressure [systolic(SBP) ≥ 140 mmHg and/or diastolic(DBP) ≥ 90 mmHg; or SBP ≥ 130 mmHg and/or DBP ≥ 80 mmHg with diabetes]. We recruited 190 patients randomized to either the HBPT or the UC groups for 12 weeks. The primary endpoints were blood pressure reduction and the proportion of patients achieving the target blood pressure.Results Totally, 172 patients completed the study, the HBPT plus support group(n = 84), and the UC group(n = 88). Patients in the plus support group showed a greater reduction in mean ambulatory blood pressure than those in the UC group. The plus support group had a significantly higher proportion of patients who achieved the target blood pressure and maintained a dipper blood pressure pattern at the12th week of follow-up. Additionally, the patients in the plus support group showed lower blood pressure variability and higher drug adherence than those in the UC group.Conclusion HBPT plus additional support results in greater blood pressure reduction, better blood pressure control, a higher proportion of dipper blood pressure patterns, lower blood pressure variability, and higher drug adherence than UC. The development of telemedicine may be the cornerstone of hypertension management in primary care.