Remote care for uncontrolled hypertension may substantially improve cardiovascular health, mainly owing to blood pressure control.
An uncontrolled hypertension management intervention involving remote patient monitoring with team-based support showed improved outcomes in reduced cholesterol and A1c levels.Researchers conducted a retrospective, single-arm cohort study to assess whether remote monitoring with team-based care for managing hypertension can improve markers of cardiovascular health.
More than 550 adult patients with uncontrolled hypertension at five federally qualified health centers were included. The patients received home BP monitors and smartphone-based virtual coaching from a team of a nurse practitioner, registered nurse, and community health worker and were stratified into tertiles of low, intermediate, and high utilization of the intervention. They were instructed to meet online with the nurse practitioner monthly, and any treatment changes were relayed to primary care physicians. Five markers — BP, total cholesterol, glycemic control, BMI, and smoking status — were each scored as 0 , 1 , or 2 and generated a composite cardiovascular health score. The primary endpoint was a 12-month change in the cardiovascular health score for participants with a baseline score ≤ 7. Secondary endpoints included the changes in non-BP markers after 12 months.Among patients with a baseline composite cardiovascular health score ≤ 7 , the score improved from 4.5 to 5.2 at 12 months , independent of the utilization of remote BP monitoring; 66% of the gain came from an improvement in the BP score , low-density lipoprotein cholesterol levels , and fasting glucose levels were reduced only among those in the highest tertile of utilizing nurse practitioner visits (P“These findings advocate for reframing remote patient monitoring-based hypertension management paradigms, particularly those integrating provider support, as comprehensive care models and highlight key components that merit prioritization,” the authors wrote.This study was led by Ethan Chervonski, MD, MPH, of New York University Grossman School of Medicine in New York City. It was publishedThis retrospective observational study did not establish whether utilization of the intervention caused the improvements in cardiovascular health markers. The 12-month data were available for 40%-61% of all patients for any given marker. The baseline indicators of cardiovascular health were determined by the last value recorded before enrollment.This study was supported by grants from the National Institutes of Health/National Institute on Minority Health and Health Disparities and the Health Resources and Services Administration. One author reported being on the board of Equipo Health. This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.
Myocardial Infarction Myocardial Infarction (MI) Nurse Practitioner Uncontrolled Hypertension CV Risk Cardiovascular Risk CV Risk Factors Cardiovascular Risk Factors Cardiovascular Risk Management CV Risk Management Lipids Lipids Management Blood Heart Cardiometabolic Risk Cardiometabolic Risk Factors Body Mass Index BMI New York Patient Assessment Patient Evaluation
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