Efficacy of Telemedicine in Hypertension Care through Home Blood Pressure Monitoring and Video Conferencing: Paradigm of Antihypertensive Therapy Along with Telemedicine Randomized (POATRAND) Trial Report

This article was originally published here

JMIR Cardio. 2021 Jul 28. doi: 10.2196/27347. Online ahead of print.


BACKGROUND: The burden of time is often the primary reason why patients discontinue their treatment. Telemedicine (TM) may help patients adhere to treatment by offering convenience.

OBJECTIVE: This study examined the efficacy and safety of TM for the management of hypertension in Japan.

METHODS: Patients with uncomplicated hypertension were recruited through web advertising between November 2015 and February 2017. They were then screened, stratified by office systolic blood pressure (SBP), and randomized into two groups: usual care (UC) and TM. The TM group used a 3G network-attached home blood pressure (BP) monitoring device, consulted hypertension specialists from academic hospital through virtual video visits, and received prescription medication by mail for 1 year. The UC group used the same BP monitoring device but was managed using self-recorded BP readings, such as their diary entries, and office BP taken in community practice setting.

RESULTS: Initial screening was completed by 99 patients, 54% of whom had untreated hypertension. Baseline BP was similar between the groups, but the weekly average SBP at the end of the 1-year study period was significantly lower in the TM group (1259 vs. 13112 mmHg, P = .02). SBP in the TM group was 3.4 mmHg lower in the morning and 5.8 mmHg lower in the evening. The rate of SBP control (135 mmHg) was better in the TM group (85.3% vs. 70.0%, P = .01), and significant adverse events were not observed.

CONCLUSIONS: We present evidence suggesting that antihypertensive therapy via home BP telemonitoring and virtual video visits achieves better BP control compared with conventional care. It proves to be a safe treatment alternative and should thus be further investigated.

CLINICALTRIAL: UMIN Clinical Trials Registry No. UMIN000025372; https://upload.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000029170.

PMID:34321194 | DOI:10.2196/27347