Division of Nephrology, Department of Internal Medicine, Teikyo University School of Medicine, Tokyo, Japan.
Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine, Tochigi, Japan.
Hypertens Res. 2023 May;46(5):1171-1180. doi: 10.1038/s41440-023-01224-y. Epub 2023 Feb 27.
Hypertension continues to be a principal risk factor for the occurrence of cardiovascular disorders, stroke, and kidney diseases. Although more than 40 million subjects suffer from hypertension in Japan, its optimal control is achieved only a subpopulation of patients, highlighting the need for novel approaches to manage this disorder. Toward the better control of blood pressure, the Japanese Society of Hypertension has developed the Future Plan, in which the application of the state-of-art information and communication technology, including web-based resources, artificial intelligence, and big data analysis, is considered as one of the promising solutions. In fact, the rapid advance of digital health technologies, as well as ongoing coronavirus disease 2019 pandemic, has triggered the structural changes in the healthcare system globally, increasing demand for the remote delivery of the medical services. Nonetheless, it is not entirely clear what evidence exists that support the widespread use of telemedicine in Japan. Here, we summarize the current status of telemedicine research, particularly in the field of hypertension and other cardiovascular risk factors. We note that there have been very few interventional studies in Japan that clearly showed the superiority or noninferiority of telemedicine over standard care, and that the methods of online consultation considerably varied among studies. Clearly, more evidence is necessary for wide implementation of telemedicine in hypertensive patients in Japan, and also those with other cardiovascular risk factors.
高血压仍然是心血管疾病、中风和肾脏疾病发生的主要危险因素。尽管日本有超过 4000 万人患有高血压，但只有一部分患者的血压得到了理想控制，这凸显了需要采用新方法来治疗这种疾病。为了更好地控制血压，日本高血压学会制定了未来计划，其中包括应用最先进的信息和通信技术，包括基于网络的资源、人工智能和大数据分析，被认为是有前途的解决方案之一。事实上，数字健康技术的快速发展，以及持续的 2019 冠状病毒病大流行，已经在全球范围内引发了医疗保健系统的结构性变化，对远程医疗服务的需求增加。尽管如此，目前尚不清楚有哪些证据支持在日本广泛使用远程医疗。在这里，我们总结了远程医疗研究的现状，特别是在高血压和其他心血管危险因素领域。我们注意到，日本几乎没有研究清楚地表明远程医疗优于标准护理的优越性或非劣效性的干预研究，而且在线咨询的方法在研究之间存在很大差异。显然，需要更多的证据来支持在日本广泛实施远程医疗，包括高血压患者和其他心血管危险因素患者。
