Mirsky Jacob B, Bui Tiffany X V, Grady Connor B, Pagliaro Jaclyn A, Bhatt Ami
Division of General Internal Medicine, Massachusetts General Hospital, Boston, MA, USA (JBM); Harvard Medical School, Boston, MA, USA (JBM, AB); Center for Innovation in Digital HealthCare, Massachusetts General Hospital, Boston, MA, USA (TXVB); Department of Biostatistics, Informatics, and Epidemiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA (CBG); and Division of Cardiology, Massachusetts General Hospital, Boston, MA, USA (JAP, AB).
Am J Lifestyle Med. 2022 Jul 4;19(3):431-436. doi: 10.1177/15598276221108060. eCollection 2025 Mar-Apr.
Less than a quarter of the 116 million adults with hypertension in the United States have blood pressure (BP) lower than the guideline-recommended goal of 130/80 mmHg. There is a critical need for novel interventions that integrate evidence-based recommendations-such as lifestyle medicine and home BP monitoring (HBPM)-into clinical care. In this study, we tested the hypothesis that a four-part, primary care physician-led Virtual Group Visit (VGV) series combining lifestyle medicine, Health and Wellness Coaching (HWC), and HBPM could lead to a reduction in BP and antihypertensive medications. There was a decrease in systolic (β = -.108 mmHg per day; = .046) and diastolic (β = -.058 mmHg per day; = .026) BP. Thirteen of the 22 patients (59%) who started the VGV series on medications had at least one medication dosage reduced or discontinued during the VGV series, and 8 of the 18 patients (44%) who finished the VGV series on medications had at least one medication dosage reduced or discontinued in the 180 days after the VGV series. This pilot study demonstrates for the first time that lifestyle medicine VGVs, coupled with HWC and HBPM, are associated with improved BP control and medication deprescribing.
在美国1.16亿患有高血压的成年人中，不到四分之一的人的血压（BP）低于指南推荐的130/80 mmHg目标值。迫切需要将基于证据的建议（如生活方式医学和家庭血压监测（HBPM））纳入临床护理的新型干预措施。在本研究中，我们检验了以下假设：由初级保健医生主导的、包含四个部分的虚拟小组访视（VGV）系列，结合生活方式医学、健康与 Wellness 教练指导（HWC）和HBPM，可降低血压并减少抗高血压药物的使用。收缩压（β = -0.108 mmHg/天；P = 0.046）和舒张压（β = -0.058 mmHg/天；P = 0.026）均有所下降。在开始VGV系列时正在服药的22名患者中，有13名（59%）在VGV系列期间至少减少或停用了一种药物剂量；在完成VGV系列时正在服药的18名患者中，有8名（44%）在VGV系列后的180天内至少减少或停用了一种药物剂量。这项初步研究首次表明，生活方式医学VGVs，结合HWC和HBPM，与改善血压控制和减少药物处方有关。
