New Program Helped 74% of Patients Control their Blood Pressure

The medical system tends to neglect high blood pressure patients, but a new program helped 74% of patients control their blood pressure. A new program of the American Heart Association overcame the obstacles of close follow-up of high blood pressure patients. This pilot program was provided for residents in central and northeast Pennsylvania. The researchers enrolled 205 adults for this program, with an average age of 62 years (48% women and 52% men). The program consisted of telemonitoring the blood pressure reading and a pharmacist reviewing the results of the blood pressure readings.

How the program worked

When a blood pressure reading was too high, the pharmacist would discuss a minor adjustment of the dose of the blood pressure pill. If this was not successful the pharmacist told the patient to see the physician again. Often the physician ordered another blood pressure pill. With this method 74% of the patients managed to bring their blood pressure into the normal range. The more blood pressure is controlled, the less complications like heart attacks and strokes occur.

Features of the blood pressure lowering study

• 67% of patients were able to control their blood pressure below 140/90 in the first 6 months, 74% within 12 months.
• Systolic blood pressure was lowered 3.3 mm Hg/month for those with an initial blood pressure of 150/90 mm Hg. When the initial blood pressure was 140-149/90-99 mm Hg, the pharmacist told the patient to take a higher dose of the blood pressure medication. This resulted in lowering of the blood pressure in 2.4 mmHg/month. And the blood pressure was lowered by 0.6 mm Hg/month for those with initial readings lower than 140/90 mm Hg.
• In 65% of patients there was a pharmacist interaction. The pharmacist contact lead to a 1.3 mm Hg/month decline in systolic blood pressure over time.
• During the 12 months study 46% of patients had a blood pressure medication adjustment. And physicians prescribed a new blood pressure medication in 37% of cases.
• There were fewer hospitalizations during the study period when compared to the previous 12 months.

Uniqueness of this monitoring program

Dr. Alexander Chang is a senior study author. He is a nephrologist and associate professor in the department of nephrology. In addition, he is head of the department of population health sciences at Geisinger Health in Danville, Pennsylvania. He said: “In our study, we developed a program that builds off what others have done using telemonitoring and pharmacists. By deploying these extra resources to get blood pressure under control in high-risk patients and reducing hospitalizations, we are hoping that we can help provide more justification in expanding these types of programs.”

Conclusion

The American Heart Association performed a pilot study in central and northeast Pennsylvania regarding optimal blood pressure control. Up to now physicians recommended to patients to buy blood pressure measuring devices to control their blood pressures. But this alone did not help to adjust their blood pressure readings. Instead, the pilot study employed a combination of telemonitoring patients’ blood pressure and supervision by a pharmacist. After 12 months of monitoring 74% of patients were able to control their blood pressure. There were also fewer hospitalizations during the study period when compared to the previous 12 months. Dr. Chang, one of the senior study authors suggested an adaptation of this program to other areas of the US.