Pilot study by Brigham investigators finds that an innovative care-delivery program helped 81 percent of participants achieve blood pressure control in seven weeks
Hypertension, or high blood pressure, is a widespread clinical problem affecting nearly half of all adults. Despite the serious consequences that can result from hypertension, which puts patients at increased risk for heart attacks, strokes and other cardiovascular events, elevated blood pressures often remain untreated or undertreated for years, and the control rate for hypertension hovers at just 50 percent. Seeing opportunities for improvement, innovators and clinicians at Brigham and Women’s Hospital have developed a new home-based, care-delivery program aimed to improve hypertension control rates quickly and at significantly lower cost than traditional, office-based blood pressure programs. The new approach, piloted among 130 participants, helped 81 percent of patients bring their blood pressures under control in, on average, just seven weeks. The results of the pilot study are published this week in Clinical Cardiology.
“This is a striking result, especially given the very short time frame in which control was reached: an average of seven weeks,” said corresponding author Naomi Fisher, MD, director of the Hypertension Service and Hypertension Specialty Clinic at the Brigham. “There are a few notable health care systems that have matched or exceeded this control rate, but most clinical practices do not approach this rate of success.”
To overcome some of the challenges that clinical practices face, Fisher and colleagues combined several innovative strategies to create their program. Enrolled participants each received a Bluetooth-enabled blood pressure device that could automatically transmit the blood pressure measurements patients took at home into their electronic medical records. Patients had easy and frequent access to “patient navigators”–non-physicians who had been trained to use a clinical algorithm developed by hypertension specialists. The program enabled rapid assessment and medication dosage adjustments for the patients.
The pilot was conducted as a prospective cohort study. The team enrolled 130 patients whose blood pressure was uncontrolled (greater than 140/90 mmHg). Patients were recruited from two clinics to test efficacy in two settings: a Brigham primary care clinic (800 Huntington Ave.), and the Brigham’s Watkins Cardiovascular Clinic. All adults were eligible except pregnant women and those with advanced kidney disease. Enrolled patients were given a Bluetooth-enabled blood pressure device and taught how to use it. Patients were instructed to measure their blood pressure at home twice daily in duplicate. Medication adjustments were made every two weeks until home blood pressure was controlled at <135/85 mmHg.
The team’s next step will be to scale up the program to test its generalizability and sustainability. With this approach, the team anticipates significant cost effectiveness and cost savings, in addition to the prevention of cardiovascular events and death from treating hypertension more intensively in men and women.
“The time-honored model of treating hypertension via traditional visits to the doctor is neither effective nor sustainable,” said Fisher. “Development of innovative solutions to manage hypertension effectively and efficiently, and thus reduce the cardiovascular risk burden in larger populations, is critical. Organizations can and should develop and adopt innovative technologies to create sustainable solutions for the control of hypertension.”
The Latest on: Hypertension
via Google News
The Latest on: Hypertension
- Hypertension Drug Shows Promise against Multiple Neurodegenerative Diseases on April 18, 2019 at 7:00 am
A University of Cambridge-led research team has shown how a prescription drug that is used to treat high blood pressure may represent a promising candidate for treating disorders such as Alzheimer’s ... […]
- Hypertension Drug to Treat Parkinson's and Dementia on April 18, 2019 at 5:59 am
Drug prescribed to treat high blood pressure could also aid to treat Parkinson's, Huntington's and other forms of dementia in studies carried out in mice and zebrafish at the University of Cambridge. ... […]
- Woodmen Business Buzz: Briargate medical practice named Hypertension Control Champion; and more on April 17, 2019 at 8:32 am
Southern Colorado Medicine, a primary care internal medicine practice in Briargate, has been selected as one of 18 practices nationwide to be named a 2018 Hypertension Control Champion by the ... […]
- Renal Denervation for Resistant Hypertension in the contemporary era: A Systematic Review and Meta-analysis on April 17, 2019 at 2:06 am
Renal denervation (RDN) is a catheter-based ablation procedure designed to treat resistant hypertension (RH). The objective of our study is to determine the effect of RDN on blood pressure and renal ... […]
- Impressive Growth of Pulmonary Arterial Hypertension Treatment Market Opportunity Assessment 2019-2025 on April 17, 2019 at 2:03 am
Apr 17, 2019 (Reports Monitor via COMTEX) -- Research report comes up with the size of the global Pulmonary Arterial Hypertension Treatment Market for the base year 2019 and the forecast between 2019 ... […]
- Frequent urination at night may be a sign of hypertension – Study on April 16, 2019 at 5:00 pm
A team of researchers in a new study presented at the 83rd Annual Scientific Meeting of the Japanese Circulation Society has said frequent urination in the night, called nocturia, may be linked to ... […]
- Immune mechanisms of hypertension on April 16, 2019 at 5:39 am
Hypertension affects 30% of adults and is the leading risk factor for heart attack and stroke. Traditionally, hypertension has been regarded as a disorder of two systems that are involved in the ... […]
- 5 Best Exercises to Beat Hypertension or High Blood Pressure on April 16, 2019 at 3:46 am
Once you have high blood pressure or hypertension, you are put on anti antihypertensive medication and list of dos and don’ts which include foods to eat to control high blood pressure and also those ... […]
- Normalizing BP in elderly with hypertension may up mortality on April 15, 2019 at 2:27 pm
(HealthDay)—Normalized blood pressure (BP) is associated with an increased risk for all-cause mortality for older adults during hypertension treatment, with increased risk seen in octogenarians ... […]
- Report: Frequent urination at night sign of hypertension on April 7, 2019 at 5:00 am
!-- Frequent nighttime urination a sign of hypertension -- Frequent nighttime urination a sign of hypertension A new study conducted in Japan has found that frequent night time urination, called ... […]
via Bing News