Nearly half of American adults have had their hypertension diagnosed, and patients are often encouraged to get a blood pressure monitoring device for use at home. The blood pressure of a patient can be better understood by daily home monitoring than by periodic readings at the doctor’s office.

A nationwide study directed by UC San Francisco looked at whether smartphone-compatible monitoring devices were more effective in managing hypertension than traditional blood pressure cuffs used at home. The researchers were surprised to discover that more advanced devices do not result in better blood pressure control.

Higher-end models connect through Bluetooth to smartphone apps that can give data visualization, reminders, and other capabilities.

The study was reported in JAMA Internal Medicine today.

According to the study’s corresponding author, Mark J. Pletcher, MD, MPH, a professor of epidemiology and biostatistics at UCSF, “We think this study is important because it provides practical real-world answers for doctors and patients.”

Hypertension, if left untreated, can lead to heart attacks and strokes, although less than half of patients with the illness have it under control. According to studies, high blood pressure causes half a million fatalities per year in the US. However, patients may find themselves inundated with choices while shopping online for a monitoring device: There are hundreds of products available online or in stores, with prices ranging from roughly $25 to $100.

In the latest study, researchers examined the efficiency of the two types of blood pressure-lowering devices when used by patients from over 20 medical institutions across the nation.

Researchers randomly delivered a basic gadget or a popular Bluetooth-enabled device to more than 2,000 individuals with high blood pressure, of whom around a third were Black or Hispanic. In order to make things like they are in the real world, the researchers didn’t try to change how doctors took care of patients or how patients used the devices.

“There have been a lot of studies suggesting that with home monitoring, the more support and handholding you give,” says Pletcher, “the better results you get for blood pressure control. But most of these programs are really hard and expensive to implement.

“We thought commercially available technology might help by providing patients with reminders to check their blood pressure, and the ability to visualize and understand the data.” 

According to blood pressure readings collected during doctor visits and recorded in electronic health records, patients who received the basic cuff had dropped their blood pressure by 10.6 mmHg after six months, while those who received the smartphone app had lowered their blood pressure by 10.8 mmHg.

There was no statistically significant difference in how well the devices worked or in how happy the patients were with them.

The study’s ethnic and racial diversity is crucial since poor hypertension management contributes significantly to the disproportionate impact cardiovascular disease has on Black communities. Patients of all self-reported races and ethnicities were included in the trial, and the results showed that the advanced technology did not beat the standard cuffs.

The authors claim that the results enable physicians to reliably advise their patients to buy and use whichever blood pressure monitoring equipment they want. Patients’ potential health advantages are not restricted if they would rather save money or avoid the trouble of connecting a device.

The cost of Bluetooth products is an issue, and connecting them to a smartphone takes some serious time and effort. As it turns out, none of that seems to have any advantages, Pletcher added. 

“What seems to matter is engagement and support from health care providers.” 

The investigation team is still looking into whether technology can assist doctors in motivating patients to manage their hypertension. A smartwatch-style sensor that continuously records blood pressure without the wearer having to do anything is one area of focus in particular.

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