Department of Neurosurgery, Icahn School of Medicine at Mount Sinai.
Department of Rehabilitation and Human Performance, New York, New York.
J Hypertens. 2022 Jul 1;40(7):1249-1256. doi: 10.1097/HJH.0000000000003164.
Hypertension management has several challenges, including poor compliance with medications and patients being lost to follow-up. Recently, remote patient monitoring and telehealth technologies have emerged as promising methods of blood pressure management. We aimed to investigate the role of application-based telehealth programs in optimizing blood pressure management.
Searches were performed in December 2020 using three databases: Cochrane Central Register of Controlled Trials, Embase and Ovid MEDLINE. All randomized controlled trials that included remote blood pressure management programmes were eligible for inclusion. Studies were included if blood pressure data were available for both the intervention and control groups. Following PRISMA guidelines, data were independently collected by two reviewers. Data were pooled using a random-effects model. The primary study outcomes were mean SBP and DBP changes for the intervention and control groups.
Eight hundred and seventy-nine distinct articles were identified and 18 satisfied inclusion and exclusion criteria. Overall, a mean weighted decrease of 7.07 points (SBP) and 5.07 points (DBP) was found for the intervention group, compared with 3.11 point (SBP) and 3.13 point (DBP) decreases in the control group. Forest plots were constructed and effect sizes were also calculated. Mean change effect sizes of 1.1 (SBP) and 0.98 (DBP) were found, representing 86 and 85% of the intervention group having greater SBP or DBP changes, respectively, when compared with the control group.
Remote patient monitoring technologies may represent a promising avenue for hypertension management. Future research is needed to evaluate the benefits in different disease-based patient subgroups.
高血压管理存在多种挑战，包括药物治疗依从性差以及患者失访。最近，远程患者监测和远程医疗技术已成为血压管理的有前途的方法。我们旨在研究基于应用程序的远程医疗计划在优化血压管理中的作用。
2020 年 12 月，我们使用三个数据库（Cochrane 对照试验中心注册库、Embase 和 Ovid MEDLINE）进行了检索。所有纳入远程血压管理计划的随机对照试验都符合纳入标准。如果干预组和对照组都有血压数据，则纳入研究。根据 PRISMA 指南，由两名评审员独立收集数据。使用随机效应模型对数据进行汇总。主要研究结果是干预组和对照组的平均 SBP 和 DBP 变化。
共确定了 879 篇不同的文章，其中 18 篇符合纳入和排除标准。总体而言，干预组的平均加权下降 7.07 点（SBP）和 5.07 点（DBP），而对照组的 SBP 和 DBP 分别下降 3.11 点和 3.13 点。绘制了森林图并计算了效应量。发现平均变化效应量为 1.1（SBP）和 0.98（DBP），这分别代表干预组的 SBP 或 DBP 变化比对照组分别增加 86%和 85%。
远程患者监测技术可能是高血压管理的一个有前途的途径。需要进一步研究来评估不同基于疾病的患者亚组中的获益。
