Background: Despite broad availability of antihypertensive therapy, real-world blood pressure (BP) control remains suboptimal. Insufficient monitoring and limited proactive treatment adjustments are key contributors. We evaluated whether structured telemonitoring combined with regular telephone consultations improves BP control compared with standard care.
Methods: In this single-centre, randomized controlled trial, 60 patients with uncontrolled hypertension were randomized (1:1) to either telemonitoring alone or telemonitoring plus biweekly telephone calls by a study physician for medication adjustments and prescription renewals. Participants performed twice-daily BP measurements with automated data transmission. In-hospital visits occurred at 6 and 12 months, with a crossover to the other group after the first six months. The primary outcome was time in target range (TTR) at 6 months; secondary endpoints included TTR at 12 months, and medication adherence.
Results: Participants had a mean age of 61±13 years, were predominantly male (61%) and primarily Caucasian (98%). Baseline BP averaged 161±17/97±12 mmHg), with comparable characteristics between groups.
At 6 months, the intervention group achieved greater BP reduction (systolic BP: -15.0±9.8 vs. -4.0±8.7 mmHg; diastolic BP:-9.8±6.7 vs. -1.8±5.6 mmHg; both p<0.001), and higher systolic TTR (52.2±24.2 vs. 36.0±29.2%, p=0.028). Measurement adherence was also superior (82.2±15.4 vs. 70.5±25.9%, p=0.033).
Following crossover, the former control group showed a significant BP reduction during months 6-12 (systolic BP -9.3±10.9 mmHg, p<0.001), reaching BP control comparable to the original intervention arm at 12 months (systolic BP 131±10 vs. 129±10 mmHg, p=0.428). The initial BP improvement achieved in the intervention group was maintained even after discontinuation of structured telephone support.
Conclusion: Structured telemonitoring combined with scheduled telephone follow-ups can improve BP control, with sustained effects even after discontinuation of telephone contacts. Larger, multicentre trials are warranted to confirm these findings and evaluate long-term clinical outcomes.
