Phone Monitoring May Help Lower Blood Pressure
TUESDAY May 5, 2009 -- An automated calling system helps people with hypertension be more aware of the potentially disabling or fatal consequences of their condition and helps them reduce their blood pressure, new research has found.
The study included 223 people at eight primary care clinics near Montreal. They all wore portable monitors that took 24-hour blood pressure readings. About half were given an educational booklet, a digital home blood pressure monitor and a log book, and were connected to a computer-based telephone system that called them at least once a week to get their most recent blood pressure readings. The readings were automatically relayed to their physicians and pharmacists, who took action if the readings indicated a problem.
The others were just given the educational booklet and then monitored as they normally would be.
After a year, the 24-hour blood pressure monitors showed that people in the group who had been called had an average reduction of 11.9 mm Hg in systolic blood pressure and 6.6 mm Hg in diastolic pressure, compared with reductions of 7.1 mm Hg systolic and 4.5 mm Hg diastolic for the control group.
Blood pressure readings measured in doctors' offices showed average reductions of 18.7 mm Hg systolic and 9.1 mm Hg diastolic for the group that had been called and reductions of 13.8 mm Hg and 5.6 mm Hg for the others.
More people in the telephoned group (46 percent) met the U.S. and Canadian definitions for controlled blood pressure -- less than 140/90 mm Hg -- than in the other group (29 percent).
The researchers also found that doctors treating patients in the telephoned group were more likely to add drugs or increase medication dosages. By the end of the study, people in the group that had been called were taking an average of two classes of antihypertensive drugs, compared with one for the others.
The better results were due to the regular feedback people received, said senior study author Dr. Pavel Hamet, a professor of medicine, physiology and nutrition at the University of Montreal. An automated system could be widely accepted if it proves cost-effective, he added.
The study appears in the May 5 online issue of Circulation: Cardiovascular Quality and Outcomes.
Posted: May 2009
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