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Hypertension: Information Technology to Improve Blood Pressure

LOYAL Study results published in the online edition of Circulation 

MONTREAL, May 6 /CNW Telbec/ - Help is on the way for the nearly five million Canadians suffering from hypertension. According to results from the LOYAL Study conducted in Laval, Quebec, hypertensive patients can significantly improve their blood pressure control and overall health by using an innovative, multidisciplinary hypertension management program linking primary care physicians, patients, nurses and pharmacists. Over and above standard educational materials and home blood pressure monitors, the management program allowed patients access to an interactive voice-recognition telephone support system, providing them with ongoing feedback and consultation. The technology used for the study was developed by Voice Synergies, Inc., a Quebec-based firm.

The LOYAL Study results were published yesterday in the online edition of Circulation: Cardiovascular Quality and Outcome(i). Preliminary results were presented at the Canadian Cardiovascular Congress in October, 2007, in Quebec City, Quebec.

"It is clear that in the treatment of hypertension and of other chronic diseases, having good medicine, knowledgeable physicians, dedicated pharmacists and active patient groups is not enough - we have all of those already but, despite the great progress we have made, many patients do not achieve their treatment targets," declared Dr. Pavel Hamet, LOYAL Study lead investigator, Canada Research Chair, Predictive Genomics, and Chief, Gene Medicine Services, Centre hospitalier de l'Université de Montréal (CHUM), Director, Laboratory of Molecular Medicine, Centre hospitalier de l'Université de Montréal's Research Centre (CRCHUM) and Professor at the Université de Montréal. "What we wanted to learn from LOYAL was the impact we could have by using those resources in a different, more interactive manner. Our findings confirm that a multidisciplinary, information technology-supported program does improve blood pressure control in hypertensive patients. We will work to ensure that the LOYAL findings are disseminated in an effective way so broader patient populations can benefit."

Almost a quarter of Canadian adults, roughly five million people, have hypertension.(ii) This condition is a major risk factor for stroke and coronary artery disease, peripheral vascular disease and congestive heart failure, and it increases cardiovascular risk by two to three times.(iii) Despite evidence that the early diagnosis and treatment of hypertension is associated with lowered chances of developing cardiovascular disease, only 13 per cent of hypertensive patients in Canada achieve adequate control of their blood pressure.

"In the four years and a half it has taken for LOYAL to be completed, the Quebec healthcare system has evolved along much the same lines as what LOYAL was set up to study," declared Dr. Marie-Thérèse Lussier, Associate Professor at Université de Montréal, and member of the LOYAL research team. "We now see the Quebec healthcare system evolving in the same direction, with a vision of patient-centered care from a multitude of resources, including the appropriate use of medication as outlined in the new Politique du médicament. It is indeed encouraging to see the ideas that we set out to study in LOYAL being accepted as valid throughout the system." 


The results of the LOYAL Study are the first to demonstrate that a multidisciplinary, information technology-supported program can significantly improve blood pressure control measured using ABPM (Ambulatory Blood Pressure Monitoring) in a primary care setting. The change over one year to ABPM blood pressure had decreased by 13.7 mmHg in the intervention group and by 6.8 mmHg in the usual care group, which was significantly different in favour of the intervention (margin of error p (less than) 0.0010). 


The objective of the Lowering Blood Pressure by Improving COmpliance to HYpertension Therapy through the Assistance of TechnoLogy Enhanced Tools (LOYAL) study was to develop an innovative and multidisciplinary hypertension management program linking primary care physicians, patients, nurses, and pharmacists in order to assist patients in improving their blood pressure control and overall health.

The Centre hospitalier de l'Université de Montréal's Research Centre (CRCHUM) and Pfizer Canada, in cooperation with Cité de la Santé de Laval, the Canadian Institutes of Health Research (CIHR) and Voice Synergies Inc., joined forces to conduct this innovative research into hypertension control. Other partners involved in the project: Diabète Québec, the Canadian Hypertension Society, Heart & Stroke Quebec, Agence de la Santé et des Services sociaux de Montréal, Agence de la Santé et des Services sociaux de Laval, Association québécoise des pharmaciens propriétaires and Fonds de la recherche en santé Québec.

"Having doctors write prescriptions and having medicine available in pharmacies does not automatically mean success in patient outcomes," declared Dr. Bernard Prigent, Medical Director at Pfizer. "This is why Pfizer is pleased to invest in programs like LOYAL so we can understand more about this complicated interaction. The growth of this type of research and its importance is part of a healthy overall trend that is seeing the breaking down of silos in research efforts as people realize that complex answers to health issues cannot be found within one discipline alone." 

Posted: May 2009