most of my career, I’ve focused on cardiovascular disease and hypertension. Uncontrolled
high blood pressure is the biggest factor for overall deaths in the United
States. It is also is the most significant changeable risk factor for your
health. According to researchers with Johns Hopkins, it can double your risk
for a heart attack; quadruple your odds for a stroke; raise your risk for heart
failure, vision loss, and circulation problems; and contribute to erectile dysfunction
I’m leading a project that compares two different evidence-based methods for
caring for people with uncontrolled high blood pressure to assist them in
getting it under control. One method is the standard clinic-based care with a
face-to-face visit with a doctor or nurse. The other method is telehealth care.
People get a blood pressure telemonitor at home that sends data electronically
to their health record. A pharmacist works with the care team and patient over
the phone to help them make medication and lifestyle adjustments and make sure
they’re taking their medicine as prescribed.
study, funded through the Patient-Centered Outcomes Research Institute (PCORI),
is a larger version of a previous project I had worked on. What we found in the
smaller, initial study is that overall, people had an improvement in their
blood pressure in the telehealth group. People in both groups saw an
improvement, but the telehealth group had an average of a ten-point greater drop
in their blood pressure. When we looked at whether the results differed by sex,
we found that men were even more likely than women to get their blood pressure
under control in the telehealth group.
we interviewed people from the study, we heard that the problem with treating
blood pressure and hypertension in general is that you don’t feel anything is
wrong. I am speaking anecdotally, of course, but men are more likely to avoid
going to the doctor than women. With steady home monitoring, men in particular,
and younger men especially, may discover it’s a problem that they can’t ignore.
of what makes patient-centered research unique is incorporating ideas from
patients throughout the research process. We even asked our patient advisory
board whether lower blood pressure was an outcome we should care enough about
to make it the main outcome of the study. The message we got back was
“absolutely!” Even if it’s a condition that people don’t feel, they encouraged
us to look at blood pressure as an important outcome.
course, with the prevalence of COVID-19, the subject of telehealth and what
health providers can do remotely comes up. I believe telehealth will become an
important part of routine care even after COVID-19 becomes a distant memory.
would say the beauty of telemonitoring is that you don’t have to record your
blood pressure on a piece of paper and remember to bring that information to
your doctor. Telemonitoring makes things so much easier for people if it can be
seamlessly transmitted to your doctor.
are so many things we can do remotely now: blood oxygen monitoring for people
with COVID-19, blood sugar for diabetes, sleep apnea machines that record how
effective the treatment is, and smart inhalers for asthma that can show the doctor
how often you use it and if you’re using it properly. All of this is information that could and
should be fed into your medical records your healthcare provider can see so it
can be incorporated into your care.
currently in the last year of our study and looking forward to seeing if, in a
significantly larger population, we see similar results as the initial project,
and how the result might be used to inform patients, hospitals, and healthcare
systems about how telehealth might be incorporated more into care.