Recent research developed byUC San Francisco checked whether the new monitoring devices paired with smartphones led to better management of hypertension than wristbands for blood pressure for home use: the same researchers were surprised to find that more sophisticated devices do not lead to better control of blood pressure.
When an individual is diagnosed hypertension or hypotensiondaily monitoring is highly recommended by the specialist, through the classic blood pressure cuffs for home use that offer a clearer picture than the rarer checks carried out in a specialist study.
The results of the Research have been published in the scientific journal JAMA Internal Medicine.
Basic devices, such as home blood pressure cuffs, simply display blood pressure, while higher-end models connect via Bluetooth to smartphone apps that can provide data visualization, reminders and other functionality: “We believe this study is important because it provides practical real-world answers to doctors and patients,” said the corresponding author Mark J. PletcherMD, MPH, Professor of Epidemiology and Biostatistics of the UCSF.
Researchers randomly sent home blood pressure cuffs or a popular Bluetooth-enabled device to more than 2,000 high blood pressure patients, about a third of whom identified as black or Hispanic. To replicate real-world circumstances, the researchers did not seek to influence how doctors handled patients or how patients used the devices.
After six months, patients who received the basic cuff had lowered their blood pressure by 10.6mmHg and those who received the smartphone app had lowered their blood pressure by 10.8mmHg, according to blood pressure measurements taken during visits by doctors and recorded in the electronic health records.
There was no statistically significant difference in the improvements patients saw or in their satisfaction with the devices. The racial and ethnic diversity of the study is important because the erratic management of hypertension plays a significant role in the disproportionate effect that cardiovascular disease has on black communities. In self-reported race and ethnicity patients, the study found that the new technology did not surpass basic cuffs.
The results of the research have allowed physicians to confidently advise their patients to purchase and use the blood pressure monitoring device of their choice, be it one of the blood pressure cuffs for home use or a technologically advanced ICE. stated the researchers involved in the study. Patients who prefer to save money or avoid the hassle of plugging in a device won’t limit their potential health benefits.
“There is a cost issue with Bluetooth devices, and the time and effort it takes to connect them to a smartphone isn’t really trivial. As it turns out, there doesn’t seem to be any benefit to any of this, ”Pletcher said. “What seems to matter is the commitment and support of health workers.” The discriminating factor is therefore not the effectiveness, but the cost of the devices dedicated to measuring the pressure.
It can therefore be inferred that inexpensive blood pressure cuffs for home use are as reliable as the most technologically sophisticated devices. The team is continuing to try to understand whether the technology can help doctors engage patients in controlling their hypertension. One area of particular concern is a smartwatch-style monitor that continuously monitors blood pressure without the wearer having to intervene.
The study on the effectiveness of blood pressure monitoring devices may seem trivial but in reality it is very important since during the Covid19 pandemic there has been an increase in the diagnosis of high blood pressure which, as has already been pointed out, if neglected can degenerate into heart attacks and strokes.
Eric PetersonProfessor of Cardiology and Deputy Provost and Senior Associate Dean for Clinical Research at UT Southwestern, said: “People were less active, ate more and drank more during the pandemic, which led to an increase in blood pressure. COVID has made it difficult for people to see their doctors and change their medications ”. So the problem was not just about spending on blood pressure cuffs for home use, but also about drug therapies and meeting with specialists.
“Even a few millimeters of change in blood pressure can lead to measurable differences in the risks of heart attack, stroke or heart failure. We need to keep these patients under better long-term control, ”said Dr. Peterson. “If this is within a patient program in a digital home management system, it is about how well controlled blood pressure was in the general population. I think this is just the tip of the iceberg. It could be much worse in the general population ”.
According to the ISS Epicenter: “Overall 31% of the Italian population is hypertensive and 17% is border-line. In men the values are higher in the North-East (37%) and in the North-West (32%), in women in the South (34%). In accordance with the data reported in the literature, the values increase with advancing age and in women the age-related increase is particularly evident after menopause ”.
“The proportion of hypertensive patients treated is higher in the South (63%) and lower in the North-West (49%) and in the North-East (51%). The proportion of hypertensive men treated adequately varies from 24% in the North-East and North-West, to 33% in the Center and 29% in the South; the situation among women is slightly better, 36% in the North-West, 40% in the North-East, 46% in the Center and 37% in the South ”. .
“The proportion of untreated hypertensive men remains high in all areas: 56% in the North-West, 55% in the North-East, 47% in the Center and 45% in the South; the corresponding proportions in women are 40%, 40%, 31% and 27%. It is interesting to note that a high proportion of hypertensive people (27%) do not know they are hypertensive (this proportion varies: 32% in the North-East, 30% in the North-West, 19% in the Center and 24% in the South) and of these the most have not measured their blood pressure in the last year ”.
Regarding the correct use of blood pressure cuffs for home use, Marina Alimento, cardiologist at the Decompensation Unit, Clinical and Rehabilitation Cardiology, said: “There is no reason to worry. The blood pressure measured in the right arm may be higher up to 10 millimeters of mercury (mmHg) compared to that measured in the left for an anatomical reason “.
“The column of blood that comes out of the left ventricle in fact follows a more linear path to reach the right brachial artery, through the pulsation of which we obtain the pressure measurement. To reach the brachial artery of the left arm, however, the same column of blood must travel through the aortic arch with its curvature, following a longer and more sinuous path that makes it lose a few millimeters of mercury pressure ”.
But how do you know if the blood pressure cuff has provided authentic information? Professor Alimento replied: “Theoretically, the measurement that recorded the highest pressure should be considered“ true ”. However, from a practical point of view, we remind you that generally automatic devices for measuring pressure at home are designed to measure on the left (it is better, however, to check the instructions of the device): in this case it is correct to perform the measurement from this side, even if we will take into account that a slightly lower pressure will be recorded ”.
To make sure that the performance of the blood pressure cuffs is satisfactory, just follow a few simple guidelines: “The rules are simple. The measurement must be carried out after at least five minutes of rest, in a sitting position, comfortable, in a quiet environment, at a comfortable temperature. You must not have taken caffeine for an hour, or have smoked a cigarette in the previous quarter of an hour. The arm should be supported and the bracelet should be level with the heart. The measurements should be two at least two minutes apart ”.
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