Managing hypertension at home improves results

  • Hypertension patients do better if they manage their blood pressure with at-home monitoring combined with online consultations with a pharmacist, a new study shows.

    Hypertension patients do better if they manage their blood pressure with at-home monitoring combined with online consultations with a pharmacist, a new study shows.

Published: 6/30/2008 12:25 AM

Patients with high blood pressure controlled the condition better using in-home testing and Internet consultations with a pharmacist than by working with their doctors alone, researchers found.

Almost twice as many patients who relied on testing and the pharmacist to help guide their therapy, in addition to their usual care managed their blood pressure compared with those who only worked with their doctors, according to a study in the Journal of the American Medical Association.

About one in three U.S. adults have been diagnosed with high blood pressure and less than half have the condition under control, according to the researchers. Doctors are searching for new ways for patients to control their hypertension, which can lead to stroke, heart attacks, heart failure and kidney disease if untreated.

"Patients may visit their doctors once a year or less often, but their blood pressure can be out of control between visits," said Beverly Green in a statement. Green is a family doctor and researcher at Seattle-based Group Health, a nonprofit health system. "We shifted healthcare from the doctor's office to where people live: in their homes and online."

Researchers studied 778 people ages 25 to 75 who had uncontrolled high blood pressure and divided them into three groups. One group received their usual care, which allowed them to send e-mails to their doctors and fill their prescriptions and request appointments at Group Health's Web site.

The second group was given a home blood pressure device and training to use the patient Web site in addition to the usual care.

And the final group included all the elements of the other two plus care management over the Internet by a pharmacist who could change or add prescription medicines.

About three times more people with the highest and hardest-to-treat pressure in the group receiving care management by the pharmacist got their condition under control than their counterparts in the usual care group, the researchers found.

The study findings show using the Internet, home blood pressure monitors and extra medical advice can better control hypertension than the current office-based physician-centered model, according to doctors Daniel Jones and Eric Peterson, who wrote an accompanying editorial in the journal.

"By finding new tools, ensuring appropriate use by patients and clinicians, and integrating these systems into clinical practice, it will be possible to achieve more effective and cost-effective blood pressure control and ultimately save lives," wrote Jones, president of the American Heart Association, and Peterson, a professor of medicine at Duke University Medical Center in Durham, North Carolina.

Patients are encouraged to regularly test their blood pressure levels at home, just like diabetics measure their blood sugar, according to guidelines issued in May by the American Heart Association, the American Society of Hypertension and the Preventive Cardiovascular Nurses' Association. The home readings provide a clearer picture of the condition and show if treatment is working.

The home devices are made by companies that include Kyoto-based Omron Corp., Panasonic, a unit of Osaka-based Matsushita Electric Industrial Co., and A&D Medical, a unit of A&D Co. based in Tokyo. They cost about $100.