New Smartphone App Can Help Monitor Blood Pressure Remotely

New smartphone app has been developed by Livongo, an American technology company aiming to improve the health of users and achieve better control of blood pressure and diabetes. The pilot study was conducted at Duke University School of Medicine and led by Bimal R. Shah, MD, chief medical officer of the health technology company Livongo, and assistant consulting professor at Duke University School of Medicine.

The findings of this pilot study will be presented at the American College of Cardiology's 68th Annual Scientific Session.

Testing the Efficacy of Smartphone App in Blood Pressure Control

Earlier studies have shown that making suitable lifestyle modifications and home blood pressure monitoring, also known as self-measured blood pressure monitoring can help improve blood pressure control. The study team hoped to determine whether the Livongo’s smartphone app can help achieve significant blood pressure control in people with both hypertension and diabetes. 

The primary endpoint goal was a decrease in systolic blood pressure after six weeks. The secondary endpoint measured was a reduction of diastolic blood pressure in the same period.

• The study enrolled 708 participants at an average age of 54 years, and 53 percent of them were women
• At the onset of the study, all participants were diagnosed with diabetes, and 63 percent had blood pressure greater than 130/80 mm Hg, which is the cut-off for the diagnosis of stage 1 hypertension, according to the revised guideline published by ACC and the American Heart Association (AHA) in 2017
• A small subset of patients (28.7 percent) had blood pressure readings greater than 140/90 mm Hg, the cut-off for stage 2 high blood pressure, according to ACC/AHA guidelines
• The study participants were given a blood pressure monitor and cuff that they could connect wirelessly with Livongo's smartphone app
• When the patients checked their blood pressure (on an average 4 times per week) with their smartphones nearby, the recordings were automatically transmitted to Livongo's computer servers
• After recording their blood pressure, the participants could open the app to view the results while they got tips on ways to manage their blood pressure such as better diet choices, regular exercise, weight management and reminding them to take their medications
• The app also enabled them to look at the trend in blood pressure readings over time, share the results with family members, friends, their doctor and if needed fix up a call with a health coach
• At the end of the study in six weeks, almost 40.8 percent of patients had blood pressure values less than 130/80 mm Hg, while 23.6 percent of participants still had blood pressure more than 140/90 mm Hg

The findings of the study suggest that regular monitoring of blood pressure via the smartphone app and initiating suitable interventions resulted in significant improvement in blood pressure levels. According to the Shah, patients with higher readings at the start of the study were more likely to see improvements in both systolic and diastolic blood pressure levels.

"We have shown in this pilot study that, in a population with both diabetes and high blood pressure, six weeks of remote blood pressure monitoring--accompanied by education about high blood pressure management and access to health coaches--can significantly improve blood pressure control," Shah said. "The improvement is comparable to what doctors would expect to see if a patient had started taking a low to moderate dose of a high blood pressure medication."

Future Plans

A potential limitation of the current study is that it did not include a control group that received standard care for hypertension as a comparison.

Shah and his team his colleague plan to undertake a further randomized trial in which patients are randomly assigned to either standard hypertension care or the smartphone app intervention.

Health Risks Associated with Concomitant Hypertension and Diabetes

It is estimated that 50 percent of adults in the US have hypertension and only 54 percent of them have proper control of their blood pressure. It is common for patients with hypertension to also have concomitant diabetes. Occurrence of these two conditions together increases the risk of heart disease, kidney disease or stroke by four times compared to persons with only one of these conditions.

Summary

The findings of the study indicate that a holistic approach combining remote blood pressure monitoring and provision of health tips can have a significant beneficial effect on blood pressure control. Hence, the findings of the study have to be validated in further trials.

Reference:

1. Remote Monitoring of Blood Pressure in T2D Population Decreases Systolic Blood Pressure at 6 Weeks: A Pilot Study - (https://www.acc.org/education-and-meetings/meetings/meeting-items/2018/03/12/13/48/acc19-68th-annual-scientific-session-and-expo)

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Source-Medindia