A digital self-management program using an app and a connected monitor could help lower blood pressure and maintain those improvements long-term, according to a study published in JAMA Network Open.

The study used Hello Heart devices, and was funded by the company. Two of the study’s authors were also Hello Heart employees.

TOP-LINE DATA

After one year, researchers found median systolic blood pressure was reduced for 53.0% of participants with baseline elevated blood pressure, 69.7% for those with baseline stage 1 hypertension and 85.7% with baseline stage 2 hypertension.

For those with stage 2 hypertension, 48.2% had improved their blood pressure control after four weeks, and 69.8% had improved that control after 104 weeks, or about two years.

HOW IT WAS DONE

The study included more than 28,000 U.S. adults with elevated blood pressure or hypertension, and the follow-up lasted as long as three years for some participants. 

They were enrolled between January 2015 and July 2020, and they received Hello Heart self-management program through their or their spouse’s employer-sponsored health insurance.

THE BACKGROUND

Nearly half of the adults in the U.S. have hypertension, and only about one in four of adults with the condition have it under control, according to the Centers for Disease Control and Prevention.

Hypertension increases the risk of having a heart attack or a stroke, which are leading causes of death in the U.S.

CONCLUSION

The researchers said the study’s strengths include the large population and the long follow-up time, up to three years for some participants. 

On the downside, the participants were all middle-aged people with employer-sponsored health insurance, so it's unclear whether the intervention would work as well for older people or those in the safety net population. However, researchers did account for age, gender, depression, anxiety, diabetes, high cholesterol, smoking, region and socioeconomic status in the participants’ neighborhoods.

The study authors also note there could be a selection bias when losing participants at follow-up, since it’s possible the more health-conscious participants were more likely to keep up with the program.

There could also be blood pressure or smartphone measurement errors. 

“In this study, participants in a BP self-management program with a BP monitor connected to a smartphone app with automated lifestyle coaching on BP control achieved long-term control of BP,” the study’s authors wrote. “This real-world evidence suggests that mobile technology may be useful for BP monitoring and control.”