BLOOD PRESSURE TELEMONITORING EFFECTIVENESS IN PATIENTS WITH UNCONTROLLED HYPERTENSION: IMPACT ON ANXIETY AND DEPRESSION

Objective: To estimate the efficacy of home blood pressure (BP) telemonitoring in patients with uncontrolled hypertension (UCHT) from specialized hypertension excellence center. Design and method: 62 ambulant patients with prior diagnosis of UCHT were invited to assign into this pilot study with use of secure web-site designed for patient-doctor communication only. All patients signed the informed consents and filled in HADS. 37 patients were enrolled to the procedures of BPTM for 3 month follow-up period: 27 males (73%), 10 female (27%) 45 ± 9 years old in comparison to 25 hypertensive patients matched by age and sex (15 males and 10 females 48 ± 8 years old) randomized to usual care.BP level changes were evaluated by office BP measurements initially, at 8 and 12 week visits in intervention group also confirmed by ABPM. Mean number of home BP self-measurements by subjects was 14 per week. Results: Mean office BP level (158 ± 8/89 ± 9 mmHg) reduced to 134 ± 6/78 ± 7 mmHg (p < 0,95) after 3 months in BPTM group. In 35 cases (95%) target BP levels have been achieved at the end of follow-up period. Furthermore, 21 (57%) subjects achieved BP targets at first 8 weeks and 14 (38%) patients achieved target BP by the end of study. Truly resistant HTN was detected in 2 (5%) patients. Systolic BP level reduction was associated with male gender (OR= 1,6, p < 0,05), age (r = -0,37, p < 0,05) also with high levels of anxiety (8 points HADS or higher) – r = 0,4, p < 0,05 and depression (8 points HADS or higher) - r = 0,5 p < 0,05. Usual care group characterized by higher values of office BP at the end-point (157 ± 9/90 ± 7 to 148 ± 9/85 ± 8 mmHg) and lower levels in HADS scale. Conclusions: Home BPTM is an effective method for clinical improvement in patients with UCHT. This method is can be even more effective in males, in younger age and in the presence of anxiety and depression.