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家庭血压和远程医疗:COVID-19 大流行期间和之后管理高血压的现代方法。

Home Blood Pressure and Telemedicine: A Modern Approach for Managing Hypertension During and After COVID-19 Pandemic.

机构信息

Hypertension Unit, Division of Cardiology, Department of Clinical and Molecular Medicine, Faculty of Medicine and Psychology, University of Rome "Sapienza", Sant'Andrea Hospital, Via di Grottarossa 1035-9, 00189, Rome, Italy.

出版信息

High Blood Press Cardiovasc Prev. 2022 Jan;29(1):1-14. doi: 10.1007/s40292-021-00492-4. Epub 2021 Dec 2.

Abstract

Hypertension is the most common cardiovascular risk factor for acute cardiovascular outcomes, including acute coronary disease, stroke, chronic kidney disease and congestive heart failure. Despite the fact that it represents the most prevalent risk factor in the general population, mostly in elderly individuals, its awareness is still relatively low, being about one third of patients living with undiagnosed hypertension and high risk of experiencing acute cardiovascular events. In addition, though recent improvement in pharmacological and non-pharmacological therapeutic options, hypertension is largely uncontrolled, with about 35-40% of treated hypertensive patients achieving the recommended therapeutic targets. Among different modern interventions proposed for improving blood pressure control in treated hypertensive patients, a systematic adoption of home BP monitoring has demonstrated to be one of the most effective. Indeed, it improves patients' awareness of the disease and adherence to prescribed medications and allows tailoring and personalizing BP lowering therapies. Home BP monitoring is particularly suitable for telemedicine and mobile-health solutions. Indeed, in specific conditions, when face-to-face interactions between patients and physicians are not allowed or even suspended, as in case of COVID-19 pandemic, telemedicine may ensure effective management of hypertension, as well as other cardiovascular and non-cardiovascular comorbidities. This review will summarize strengths and limitations of telemedicine in the clinical management of hypertension with a particular focus on the lessons learned during the COVID-19 pandemic.

摘要

高血压是急性心血管结局的最常见心血管风险因素,包括急性冠状动脉疾病、中风、慢性肾脏病和充血性心力衰竭。尽管它是普通人群中最常见的风险因素,主要发生在老年人中,但人们对其认识仍然相对较低,大约有三分之一的未确诊高血压患者和发生急性心血管事件的高危患者。此外,尽管在药物和非药物治疗选择方面有了最近的改进,但高血压的控制率仍然很低,约 35-40%的高血压患者接受治疗后达到了推荐的治疗目标。在为改善治疗高血压患者的血压控制而提出的不同现代干预措施中,系统采用家庭血压监测已被证明是最有效的措施之一。事实上,它提高了患者对疾病的认识和对规定药物的依从性,并允许调整和个性化降压治疗。家庭血压监测特别适用于远程医疗和移动医疗解决方案。事实上,在某些情况下,当不允许甚至暂停患者与医生之间的面对面互动时,如在 COVID-19 大流行期间,远程医疗可以确保高血压以及其他心血管和非心血管合并症的有效管理。这篇综述将总结远程医疗在高血压临床管理中的优势和局限性,特别关注在 COVID-19 大流行期间吸取的经验教训。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/535e/8638231/7912f188a9ba/40292_2021_492_Fig1_HTML.jpg

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