Blood Pressure
Loren Bonner
Do apps really make everything better? It turns out this may not be the case for blood pressure (BP) devices connected to smartphone applications.
Researchers of a new study published August 15, 2022, in JAMA Internal Medicine found that BP results were nearly identical between patients who were randomized to a standard BP device versus an enhanced device that connects to a smartphone app.
The research team had hoped a BP app could help patients make at-home BP management more efficient, but the study findings showed it wasn’t helpful.
“We work with a patient advisory board,” said lead author Mark Pletcher, MD, MPH. “The very simple question was posed by one of our patient advisors about what kind of home blood pressure monitor patients should buy, now that there are devices that connect with a smartphone. That struck us as a simple and relevant question that we could answer with a research study.”
A diverse set of over 2,000 patients with high BP were divided into 2 groups. The people in one group were sent an OMRON BP monitor. Those in the other group were given the same monitor along with instructions to set up the OMRON Connect smartphone app. They followed up with group participants 6 months later and found that both groups had small reductions in their BP, but there were no differences between the groups.
“For a patient purchasing a device to initiate home monitoring for their BP, they need not spend extra money on one that connects with their smartphone—a regular device appears to be just as good,” said Pletcher, who is with the Department of Epidemiology and Biostatistics at the University of California, San Francisco.
The results should give patients and clinicians pause, especially as tech companies continue to work on building BP monitoring mechanisms into smartwatches and other smart devices, just as they have done with heart rate monitoring.
Pharmacists and BP management
According to CDC, close to half of adults in the United States have high BP, and only 25% of those individuals have their BP under control.
Helping millions of Americans control their BP is a major goal for the nation, and research has shown that having patients check their BP at home is simply not enough. Patients benefit from regular counseling along with at-home BP monitoring.
As some of the most accessible health care professionals, pharmacists have demonstrated they can help control BP for patients. In the latest Surgeon General’s Call to Action to Control Hypertension, for example, which aimed to make hypertension control a national public health priority, pharmacists were called out for their value in hypertension control efforts. Cited was the University of Michigan Health Hypertension Pharmacists’ Program.
A CDC evaluation of this program found that 66% of participants in the pharmacist-led hypertension program achieved BP control within 3 months of starting the program, compared to only 42% of nonparticipants.
Strengths and limitations
Pletcher said that while the results of the JAMA Internal Medicine study are relatively definitive, they do not address situations in which a practice or health system has a more comprehensive hypertension program that may include outreach and education for patients, seamless BP measurements connected through an electronic health record, or other enhancements.
“We really just provided the devices to patients and let them and their clinicians do the rest,” he said. “In that context, it’s clear that just the connected smartphone app didn’t really add anything.”
Pletcher also noted that they used BP measurements in the office for assessing the outcome. “Office measurements of blood pressure are not always reliable, and are subject to ‘white coat’ syndrome,” Pletcher said. ■