Accepted for/Published in: Journal of Medical Internet Research
Date Submitted: Jul 28, 2020
Date Accepted: Nov 5, 2020
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Synchronous Telehealth Services with Digital Platform Decreases Day-by-Day Home Blood Pressure Variability in Patients with Cardiovascular Diseases: Retrospective Cohort Study
ABSTRACT
Background:
Hypertension is associated with a large global disease burden with variable controlled rate across different regions and races. Telehealth has recently emerged as a healthcare strategy for managing chronic diseases, but there have been few reports regarding the effects of synchronous telehealth services on home blood pressure (BP) control and variability.
Objective:
This study aimed to investigate the effect of fourth-generation synchronous telehealth services on home blood pressure.
Methods:
This retrospective study was conducted by the TELEHEALTH study group at the Telehealth Center in National Taiwan University Hospital. We analyzed home BP data taken from 2,888 cardiovascular disease patients who were enrolled in our telehealth program and received telehealth services between 2009 and 2017. Mean, standard deviation (SD), coefficient variability (CV), and average real variability (ARV) were calculated.
Results:
A total of 398 patients who underwent constant home BP surveillance for ≥ 2 months were recruited for this study. Patients were stratified into three groups: (1) Poorly-controlled hypertension, (2) Well-controlled hypertension, and (3) Non-hypertension. Telehealth significantly reduced systolic BP in the poorly-controlled hypertension group from 145.2±9.3 mmHg to 132.8±10.3 mmHg after 2 months (P<.001). BP variability was reduced in all patients: SBP-SD decreased from 7.7±3.4 to 7.1±3.2 after 2 months (P<.001), and SBP-CV decreased from 6.2±2.5 to 5.7±2.4 after 2 months (P<.001). Event free survival (admission) analysis stratified by SBP-SD showed longer time to first hospitalization for Q1 patients compared with Q4 patients (P=.04).
Conclusions:
Synchronous telehealth intervention may improve home BP control and decrease day-by-day home BP variability in patients with cardiovascular disease.
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