Nakamoto Hidetomo, Nishida Eiichi, Ryuzaki Munekazu, Sone Masayoshi, Suzuki Hiromichi, Yoshimoto Mitsuo, Itagaki Kaoru
Department of Nephrology, Saitama Medical School, Saitama, Japan.
Clin Exp Hypertens. 2008 Jan;30(1):57-67. doi: 10.1080/10641960701815804.
We have developed a new home blood pressure (BP) monitoring system by using cellular telephone and the Internet. All data of home BP and pulse rate were directly collected by I-converter date collecting system and sent online to a main server constructed in a central data center. The home doctor can monitor the exercise data of each patient by using this system. This home BP monitoring system was directly connected to the Internet by using application service provider technology (ASP). Anytime and anywhere, each patient can check the changes of these parameters by themselves by using cellular telephone and/or the Internet. The average of the data was calculated and demonstrated online. In real time, all data were monitored and sent to the home doctor's office. In the present study, we tried to use this monitoring system to compare the effect of some antihypertensive drugs on home BP. To compare the effects of telmisartan (TEL) and amlodipine (AM) on home BP, home BP was monitored for eight weeks using this telemedicine system. The target point of office BP was 140/90 mmHg or less. After two weeks control period, telmisartan (TEL group: 20-80 mg/day, n = 21) or amlodipine (AM group: 2.5-10 mg/day, n = 19) was orally administrated once a day in the morning. There was no significant difference of office BP between these two groups. Systolic home BP was significantly decreased from 144 +/- 4 to 134 +/- 3 mmHg (TEL group) and from 143 +/- 4 to 135 +/- 3 mmHg (AM group), respectively. There was no significant difference in the changes of home BP in the morning between groups (eight weeks home systolic BP reduction, TEL: 15 +/- 2 mmHg, AM: 13 +/- 2 mmHg). However the reduction of home BP in the evening in TEL group was significantly bigger than AM group (eight weeks home systolic BP reduction, TEL: 13 +/- 3 vs. AM: 6 +/- 3 mmHg). From these data, we concluded that there is a big difference on the effects of antihypertensive agents on diurnal variation and 24hr overall BP variability in home BP. TEL has a good effect on home BP for 24 hours compared to AM. This telemedicine system has a great advantage in monitoriong home BP correctly in hypertensive patients.
