Hypertension Management Using Telemonitoring

Patients with elevated BP, identified by the electronic medical record, will be recruited for study enrollment. Patients will be mailed a telemonitoring kit including an electronic tablet equipped with a wireless BP cuff that transmits measurements directly to the UMMC electronic medical record and monitored by the UMMC Center for Telehealth. Patients will participate in a 6 month intervention period during which they will transmit daily BP recordings with regular contact by a Telehealth nurse coordinator who will provide education and encourage healthy lifestyle habits. Every 2 weeks BP medications will be adjusted according to an evidence-based treatment algorithm managed by the Center for Telehealth pharmacist using a standardized physician-approved protocol. Data analysis will track metrics of study enrollment, study completion, safety, therapeutic intensification, and BP change from baseline.

Inclusion criteria

• Age greater than 18 years
• Patient of UMMC clinician approving the study
• At least 2 clinic encounters in the past 12 months with systolic BP ≥ 140 mmHg and/or diastolic BP ≥ 90 mmHg

Exclusion criteria

• Stage 4 or 5 chronic kidney disease
• Systolic heart failure (LVEF <50%) or major cardiovascular event (MI, stroke) within 3 months
• Resistant hypertension (prescribed 3 or more antihypertensive medications at target doses) or known secondary cause of hypertension
• Pregnancy or inability/unwillingness to use birth control for women of child-bearing potential
• Institutionalized, dementia, limited life expectancy, uncontrolled mental illness, substance abuse, or other conditions that would prohibit ability to perform regular home BP monitoring