Kim Yoon-Nyun, Shin Dong Gu, Park Sungha, Lee Chang Hee
Department of Internal Medicine, Division of Cardiology, Keimyung University College of Medicine, Daegu, Korea.
Department of Internal Medicine, Cardiovascular Division, Yeungnam University college of medicine, Daegu, Korea.
Hypertens Res. 2015 Jul;38(7):491-7. doi: 10.1038/hr.2015.32. Epub 2015 Mar 19.
The effectiveness of remote patient monitoring and physician care for the treatment of hypertension has not been demonstrated in a randomized clinical trial. The objective of this study was to evaluate the effectiveness of remote patient monitoring with or without remote physician care in reducing office blood pressure in patients with hypertension. A total of 374 hypertensive patients over 20 years of age were randomized into the following three groups: group (1) control, the patients received usual clinical care with home BP monitoring; group (2) the patients were remotely monitored and received office follow-up; and group (3) the patients received remote monitoring without physician office care using the remote monitoring device. For each group, in-office follow-up care was scheduled every 8 weeks for 24 weeks. The primary end point was the difference in sitting SBP at the 24-week follow-up. No difference between the three groups was observed in the primary end point (adjusted mean sitting SBP was as follows: group 1: -8.9±15.5 mm Hg, group 2: -11.3±15.9 mm Hg, group 3: -11.6±19.8 mm Hg, (NS). Significant differences in achieving the target BP at the 24th week of follow-up were observed between groups 1 and 2. The subjects over 55-years old had a significant decrease in the adjusted mean sitting SBP in groups 2 and 3 compared with that of the control group. Remote monitoring alone or remote monitoring coupled with remote physician care was as efficacious as the usual office care for reducing blood pressure with comparable safety and efficacy in hypertensive patients.
远程患者监测和医生护理对高血压治疗的有效性尚未在随机临床试验中得到证实。本研究的目的是评估有或没有远程医生护理的远程患者监测在降低高血压患者诊室血压方面的有效性。共有374名20岁以上的高血压患者被随机分为以下三组:(1)对照组,患者接受常规临床护理并进行家庭血压监测;(2)患者接受远程监测并接受诊室随访;(3)患者使用远程监测设备接受无医生诊室护理的远程监测。对于每组,每8周安排一次诊室随访护理,共24周。主要终点是24周随访时坐位收缩压的差异。在主要终点方面,三组之间未观察到差异(调整后的平均坐位收缩压如下:第1组:-8.9±15.5 mmHg,第2组:-11.3±15.9 mmHg,第3组:-11.6±19.8 mmHg,(无显著性差异)。在随访第24周时,第1组和第2组在达到目标血压方面存在显著差异。与对照组相比,55岁以上的受试者在第2组和第3组中调整后的平均坐位收缩压显著降低。单独的远程监测或与远程医生护理相结合的远程监测在降低血压方面与常规诊室护理同样有效,在高血压患者中具有相当的安全性和有效性。