Pharmacist-led Telemonitoring of Patients with High Blood Pressure Reduces Heart Attack, Stroke Rate

According to a new study, patients enrolled in a pharmacist-led telemonitoring program to control high blood pressure were about half as likely to experience a heart attack or stroke compared with patients receiving routine primary care.

Uncontrolled hypertension is the largest modifiable risk factor contributing to death from all causes in the United States, with nearly half of American adults diagnosed with high blood pressure, according to the study. The authors noted that most adults, however, do not have their numbers under control.

The study, which was conducted by the American Heart Association, enrolled 450 participants with uncontrolled high pressure at 16 primary care clinics in Minnesota. The participants were blinded and randomized into 2 groups to receive either routine primary care or telemonitoring with 1 year of remote care managed by a pharmacist.

In the telemonitoring group, patients were able to measure their blood pressure at home and send it electronically to the pharmacist, who could then make medication and lifestyle changes when necessary. According to a press release, heart attack, stroke, stent placement, or heart failure hospitalization occurred in 5.3% of the telemonitored group compared with 10.4% of the routine primary care group.

Specifically, in the telemonitoring group there were 15 serious cardiovascular events among 10 patients, compared with 26 serious cardiovascular events among 19 patients in the routine primary care group. Based on these findings, widespread adoption of this model might help adults in the United States with uncontrolled high blood pressure avoid serious cardiovascular events, according to the authors.

“Home blood pressure monitoring linked with treatment actions from the health care team delivered remotely (telehealth support) in between office visits has been shown to lower blood pressure more than routine care, and patients really like it,” said study author Karen L. Margolis, MD, MPH, in a press release. “In addition, by avoiding serious cardiovascular events over 5 years, our results indicate significant cost savings.”

According to the press release, the patients reported that they liked having support from a trusted professional, rapid feedback and adjustments to their treatment, and having someone to be accountable to. Furthermore, over 5 years, the savings from reduced cardiovascular disease events exceeded the telemonitoring intervention costs by $1900 per patient.

“The findings were just short of statistical significance, meaning they could have been due to chance,” Margolis said. “However, we were surprised that the figures on serious cardiovascular events pointed so strongly to a benefit of the telemonitoring intervention.”

REFERENCE

For people with high blood pressure, telemonitoring may cut heart attack, stroke rate by 50% [news release]. American Heart Association; August 31, 2020. https://newsroom.heart.org/news/for-people-with-high-blood-pressure-telemonitoring-may-cut-heart-attack-stroke-rate-by-50?preview=c1c7. Accessed October 8, 2020.