Kitt J, et al. Curr Hypertens Rep. 2019 Apr 25;21(6):44.
Kitt J, et al., conducted a review study to estimate how emerging technologies can support improved detection and hypertension management not for only wider population but also for specific patient groups such as the elderly, pregnant women, and those with atrial fibrillation.
Self-monitoring of BP – It can help to improve BP control and is a progressively prevalent part of hypertension management. As compared to clinic measurement, it is well tolerated by patients and presented as a better predictor of end organ damage.
Tele-monitoring – It is a particular function of telemedicine—it transfers data incidentally —which in this case consists of automatic data transmission of BP readings. In a large meta-analysis, all studies indicates a higher acknowledgment of the technologies by doctors and patients, good constancy to tele-monitoring programs and proved that the technology has the potential to enhance management of hypertension, improve patient outcomes, and decrease healthcare costs, especially while considering long-term follow-up.
‘Virtual clinics/visits’ – A study by Levine, et al. in 2018 explained that for primary care patients managed for hypertension with a virtual visit vs. a real-life in-person visit showed no significant adjusted difference in systolic blood pressure control, number of specialist visits, emergency department presentations, or inpatient admissions.
Other novel advances in hypertension management – Artificial intelligence established interfaces such as Alexa® and Siri® which can wirelessly update lists of medication and set reminders to improve treatment adherence.
Addition of tele-monitored data on BP into digital healthcare programmes can now also enable combination with other physiological variables including blood glucose, heart rate and exercise allowing adaptation of management recommendations established on proposed variables including user demographics, indicated morbidities and co-morbidities, self-identified barriers and actions recorded over the course of a programme or set by a physician. Examples of this include the ‘WellDoc Hypertension and diabetes management platform’ and ‘Omada Health’s digital program’.
Implementation of Technology in Special Groups
Atrial Fibrillation – A current systematic review examined studies containing 14 different automated BP devices to analyse if their efficiency has improved as technology and detection algorithms have advanced in the presence of AF. This specific review concluded that a BP device seems accurate for patients in sinus rhythm cannot be assumed to maintain accuracy when used to measure BP in those with AF. Consequently, in patients with AF, measurement, and management of BP remains an area in which further evolution of new technology is required to allow more precise monitoring and management.
Pregnancy – Self-monitoring of BP has been shown to be suitable in pregnancy and to have the potential to identify hypertensive disorders rapidly than standard care.
Children – In the paediatric patients, the issues of technology validation are shown to be more acute because children’s vasculature and arm size are not the similar as those of adults. The new universal standard prepared recommendations aiming to improve this.
Thus, it was concluded that novel technology including smartphones and Bluetooth®-implemented tele-monitoring are evolving as pivotal players in management of hypertension and provides specific assurance within pregnancy and developing countries. New technologies are therefore needed to properly assess and clinically validate prior to widespread implementation in the general population.
