Blood pressure telemonitoring and the incidence of cardiovascular events: a records based, matched patient analysis

It is well established from trials that blood pressure (BP) telemonitoring leads to improved BP control. However, there is little data available on the impact of BP telemonitoring on the incidence of cardiovascular events when it is used as the routine mode of long-term BP monitoring. The objective of this study was to assess the impact of BP telemonitoring on cardiovascular outcomes.

Records were analysed for 454 180 adults with hypertension who had a prescription for a first-line anti-hypertensive drug at any time from 1 March 2019 to 28 February 2021. Follow-up was until 1st March 2022. Women pregnant during that time were excluded. The primary outcome was emergency hospital admission or mortality for Acute Coronary Syndrome (ACS), Stroke, or uncontrolled Heart Failure (HF) within 12 months. Outcomes were compared between people who had used BP telemonitoring for at least 1 year and a group who had never used it, matched for age, sex, ethnicity, social deprivation, number of anti-hypertensive drugs, diabetes, and having a BP assessment in the same year. Ninety percent of the cohort had been diagnosed with hypertension before March 2019. The onset of the COVID-19 pandemic in March 2020 was associated with a rapid increase in the uptake of BP telemonitoring but a reduction in the number of new diagnoses of hypertension. Those who used telemonitoring were significantly younger, less likely to have diabetes, and took less antihypertensive medication. For those who used telemonitoring for over 1 year, a mean reduction in systolic BP was seen by 3 months which was maintained for at least the remainder of the year.

In the matched cohort analysis, people who used telemonitoring were less likely to be admitted to hospital with or die from ACS, stroke, or uncontrolled HF telemonitoring [adjusted OR 0.665 (0.501 to 0.884), P = 0.0049] than those who were not using telemonitoring.