JMIR Publications

ABSTRACT

Background:

Hypertension is a leading cardiovascular risk factor, yet only about half of affected individuals achieve blood pressure (BP) control, with persistent disparities among low-income and racial/ethnic minority populations. Wireless home blood pressure monitoring (HBPM) integrated with remote patient monitoring shows promise for improving BP management, but evidence is limited in medically underserved, predominantly Hispanic populations served by Federally Qualified Health Centers (FQHCs).

Objective:

This pilot study aimed to evaluate the feasibility and acceptability of wireless HBPM among predominantly Hispanic adults with hypertension receiving care at FQHCs and to explore its effect on BP control compared with conventional HBPM using paper logs.

Methods:

We conducted a 6-month prospective, two-arm randomized controlled pilot trial nested within the San Diego: Heart Attack and Stroke Free Zone cardiovascular risk-reduction program. Adults aged ≥18 years with uncontrolled or newly diagnosed hypertension (BP ≥140/90 mmHg) were enrolled across three FQHC networks and randomized to a wireless HBPM arm (Qualcomm Life 2NET hub with an A&D UA-651 BLE monitor; weekly transmitted summaries reviewed by health coaches) or a standard arm (calibrated home BP monitor with paper log). Both arms received standardized health coaching. Feasibility was defined as the proportion of expected BP readings successfully transmitted; acceptability was assessed via a post-intervention satisfaction survey in the wireless arm. Exploratory analyses compared BP outcomes between arms using t-tests, chi-square/Fisher exact tests, and multivariable logistic regression.

Results:

Of 200 participants (73 wireless; 127 standard), mean age was 61 years, 57% were women, and 51% self-identified as Hispanic, with no significant baseline differences between arms. In the wireless arm, 86% (63/73) successfully transmitted multiple readings, with a median of 159 readings (mean 160.6, SD 129.1) over 6 months, corresponding to 76.2% adherence to the prescribed schedule; only 5% of standard-arm participants returned their paper logs. On the satisfaction survey (response rate 82.2%), 95% agreed or strongly agreed that the device was easy to set up and use, and 75% reported they would more consistently use the wireless than the conventional cuff. Both arms showed significant reductions in systolic and diastolic BP at 6 months (P<.001). At 6 months, 63% of the wireless arm and 74% of the standard arm achieved systolic BP <140 mmHg (P=.079); adjusted analyses showed no significant between-group difference in BP control (adjusted odds ratio 1.6, 95% CI 0.78-3.4; P=.19).

Conclusions:

Wireless HBPM was feasible and highly acceptable in a medically underserved, predominantly Hispanic FQHC population, with strong data-transmission adherence and high user satisfaction. Although this pilot was not powered for definitive efficacy comparisons, the findings support wireless HBPM as a viable platform for hypertension management in underserved settings and offer foundational evidence to inform contemporary digital health and remote patient monitoring program design.