Differentiated Effects and Determinants of Home Blood Pressure Telemonitoring: Three-Year Cohort Study in Jieshou, Anhui, China

Bibliographic Details
Title: Differentiated Effects and Determinants of Home Blood Pressure Telemonitoring: Three-Year Cohort Study in Jieshou, Anhui, China
Authors: Qun Xue, Xuewu Zhang, Rong Liu, Xiaoqin Guan, Guocheng Li, Linhai Zhao, Qian Wang, Debin Wang, Xingrong Shen
Source: Journal of Medical Internet Research, Vol 24, Iss 10, p e37648 (2022)
Publisher Information: JMIR Publications, 2022.
Publication Year: 2022
Collection: LCC:Computer applications to medicine. Medical informatics
LCC:Public aspects of medicine
Subject Terms: Computer applications to medicine. Medical informatics, R858-859.7, Public aspects of medicine, RA1-1270
More Details: BackgroundHome blood pressure telemonitoring (HBPT) is witnessing rapid diffusion worldwide. Contemporary studies documented mainly short-term (6-12 months) effects of HBPT, and there are limited data about its uptake. ObjectiveThe aim of this study was to explore the 3-year use and determinants of HBPT, and the interactions with systolic and diastolic blood pressure (SBP/DBP) and overall blood pressure (BP) control rate. MethodsHBPT records were obtained from a 3-year cohort of 5658 patients with hypertension in Jieshou, Anhui, China, and data from a structured household survey of a random sample (n=3005) of the cohort. The data analysis comprised (1) timeline trajectories of the rates of monthly active HBPT and mean SBP/DBP for overall and subgroups of patients with varied start-month SBP/DBP; and (2) multivariable linear, logistic, and percentile regression analyses using SBP/DBP, BP control rate, and yearly times of HBPT as the dependent variable, respectively. ResultsHBPT was followed by mixed changes in mean monthly SBP/DBP for varied patient groups. The magnitude of changes ranged from –43 to +39 mmHg for SBP and from –27 to +15 mmHg for DBP. The monthly rates of active HBPT all exhibited a rapid and then gradually slower decline. When controlled for commonly reported confounders, times of HBPT in the last year were found to have decreasing correlation coefficients for SBP/DBP (from 0.16 to –0.35 and from 0.11 to –0.35, respectively) and for BP control rate (from 0.53 to –0.62). ConclusionsHBPT had major and “target-converging” effects on SBP/DBP. The magnitude of changes was much greater than commonly reported. BP, variation in BP, and time were the most important determinants of HBPT uptake. Age, education, duration of hypertension, family history, and diagnosis of hypertension complications were also linked to the uptake but at weaker strength. There is a clear need for differentiated thinking over the application and assessment of HBPT, and for identifying and correcting/leveraging potential outdated/new opportunities or beliefs.
Document Type: article
File Description: electronic resource
Language: English
ISSN: 1438-8871
Relation: https://www.jmir.org/2022/10/e37648; https://doaj.org/toc/1438-8871
DOI: 10.2196/37648
Access URL: https://doaj.org/article/a40377aa29284aaf8920798acdb674ae
Accession Number: edsdoj.40377aa29284aaf8920798acdb674ae
Database: Directory of Open Access Journals
Full text is not displayed to guests.
More Details
ISSN:14388871
DOI:10.2196/37648
Published in:Journal of Medical Internet Research
Language:English