scholarly journals The impact of changing home blood pressure monitoring cutoff from 135/85 to 130/80 mmHg on hypertension phenotypes

2021 ◽  
Author(s):  
Audes D.M. Feitosa ◽  
Marco A. Mota‐Gomes ◽  
Weimar S. Barroso ◽  
Roberto D. Miranda ◽  
Eduardo C.D. Barbosa ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Blood Pressure Monitoring ◽  
Home Blood Pressure ◽  
Home Blood Pressure Monitoring ◽  
Pressure Monitoring ◽  
The Impact

Abstract 16986: Reduced Medical Spending Overtime With Use of a Home Blood Pressure Monitoring Program

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Roberta James ◽  
Wei Lu ◽  
Jennifer Schnieder ◽  
Bimal R Shah
Keyword(s):  
Blood Pressure ◽  
Nearest Neighbor ◽  
Blood Pressure Monitoring ◽  
Monitoring Program ◽  
Home Blood Pressure ◽  
Home Blood Pressure Monitoring ◽  
Pressure Monitoring ◽  
Exact Matching ◽  
Medical Spending ◽  
The Impact

Background: Livongo’s Applied Health Signals Home Blood Pressure Monitoring Program (HBMP) offers patients a Bluetooth connected blood pressure cuff, hypertension (HTN) management education, and access to health coaches. Previous studies have demonstrated the clinical benefits of HBPM so the objective of this study was to also evaluate the impact on U.S. medical spending within the first year. Methods: People younger than 65 years with continuous enrollment in health benefits for the 12 months before and 12 months after launch of the HBMP and use of the program for at least three months were selected. Medical spending for those participants was compared to eligible but non-HBMP participant controls who were identified utilizing propensity score with nearest-neighbor matching methodology on age, gender, and pre-period medical spending with exact matching on Charlson Comorbidity Score Index in a 1:1 ratio. People with medical spending exceeding $50,000 monthly or $100,000 annually were excluded from the analysis. The HBPM participant baseline blood pressures were compared to BP values at 12-months to assess improvement in BP management. Mean medical spending based on the total allowed amounts per member per month (PMPM) was compared between the HBPM and non-HBPM groups using intention-to-treat difference-in-difference (DiD) analysis. Results: There were 1,417 HBPM participants with mean age of 51 years, 52% female, 64% with uncontrolled HTN (BP &gt = 130/80) at baseline, and mean pre-period medical spending of $490 PMPM. For participants with uncontrolled HTN, mean systolic and diastolic BP reductions were 14.2 mmHg and 10.1 mmHg, respectively, with 54% decreasing in HTN stage or considered controlled. The HBPM group had a 1% reduction in medical spending to $474 PMPM while the non-HBPM group had an 18% increase in medical spending from $410 PMPM to $486 PMPM resulting in a medical savings of $81 PMPM. The HBPM group also had a reduction of 33% in inpatient utilization and 14% in ED visits. Conclusion: HBPM participants experienced improved BP control and a reduction in total medical cost savings resulting in a positive return on investment. The main drivers of medical savings were a reduction in ED and inpatient hospital utilization.

scholarly journals Home Blood Pressure Monitoring

2015 ◽  
Vol 10 (2) ◽  
pp. 95 ◽  
Author(s):  
Jacob George ◽  
Thomas MacDonald ◽  
◽  
Keyword(s):  
Blood Pressure ◽  
Blood Pressure Monitoring ◽  
New Technology ◽  
Home Blood Pressure ◽  
White Coat Hypertension ◽  
Home Blood Pressure Monitoring ◽  
Pressure Monitoring ◽  
Self Monitoring ◽  
Reading Accuracy ◽  
The Impact

Hypertension is the most common preventable cause of cardiovascular disease. Home blood pressure monitoring (HBPM) is a self-monitoring tool that can be incorporated into the care for patients with hypertension and is recommended by major guidelines. A growing body of evidence supports the benefits of patient HBPM compared with office-based monitoring: these include improved control of BP, diagnosis of white-coat hypertension and prediction of cardiovascular risk. Furthermore, HBPM is cheaper and easier to perform than 24-hour ambulatory BP monitoring (ABPM). All HBPM devices require validation, however, as inaccurate readings have been found in a high proportion of monitors. New technology features a longer inflatable area within the cuff that wraps all the way round the arm, increasing the ‘acceptable range’ of placement and thus reducing the impact of cuff placement on reading accuracy, thereby overcoming the limitations of current devices.

Home Blood Pressure Monitoring Devices: Device Performance in an Alaska Native and American Indian Population

2021 ◽  
Vol 33 (7-8_suppl) ◽  
pp. 40S-50S
Author(s):  
Krista R. Schaefer ◽  
Amber L. Fyfe-Johnson ◽  
Carolyn J. Noonan ◽  
Michael R. Todd ◽  
Jason G. Umans ◽  
...  
Keyword(s):  
Blood Pressure ◽  
American Indian ◽  
Alaska Native ◽  
Blood Pressure Monitoring ◽  
Intraclass Correlation ◽  
Home Blood Pressure ◽  
Home Blood Pressure Monitoring ◽  
Pressure Monitoring ◽  
Calibration Models ◽  
American Indian People

Objectives: Home blood pressure monitoring (HBPM) is an important component of blood pressure (BP) management. We assessed performance of two HBPM devices among Alaska Native and American Indian people (ANAIs). Methods: We measured BP using Omron BP786 arm cuff, Omron BP654 wrist cuff, and Baum aneroid sphygmomanometer in 100 ANAIs. Performance was assessed with intraclass correlation, paired t-tests, and calibration models. Results: Compared to sphygmomanometer, average BP was higher for wrist cuff (systolic = 4.8 mmHg and diastolic = 3.6 mmHg) and varied for arm cuff (systolic = −1.5 mmHg and diastolic = 2.5 mmHg). Calibration increased performance from grade B to A for arm cuff and from D to B for wrist cuff. Calibration increased false negatives and decreased false positives. Discussion: The arm HBPM device is more accurate than the wrist cuff among ANAIs with hypertension. Most patients are willing to use the arm cuff when accuracy is discussed.

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