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TOPLINE:

An uncontrolled hypertension management intervention involving remote patient monitoring with team-based support showed improved outcomes in reduced cholesterol and A1c levels.

METHODOLOGY:

• Researchers conducted a retrospective, single-arm cohort study to assess whether remote monitoring with team-based care for managing hypertension can improve markers of cardiovascular health.
• More than 550 adult patients (mean age, 56 years; 65% women) with uncontrolled hypertension (BP [blood pressure] ≥ 140/90 mm Hg on two consecutive measurements during a clinic visit and nonadherence to medication) at five federally qualified health centers were included.
• The patients received home BP monitors and smartphone-based virtual coaching from a team of a nurse practitioner, registered nurse, and community health worker and were stratified into tertiles of low, intermediate, and high utilization of the intervention. They were instructed to meet online with the nurse practitioner monthly, and any treatment changes were relayed to primary care physicians.
• Five markers — BP, total cholesterol, glycemic control, BMI, and smoking status — were each scored as 0 (poor), 1 (intermediate), or 2 (ideal) and generated a composite cardiovascular health score.
• The primary endpoint was a 12-month change in the cardiovascular health score for participants with a baseline score ≤ 7. Secondary endpoints included the changes in non-BP markers after 12 months.

TAKEAWAY:

• Among patients with a baseline composite cardiovascular health score ≤ 7 (n = 196), the score improved from 4.5 to 5.2 at 12 months (P < .001), independent of the utilization of remote BP monitoring; 66% of the gain came from an improvement in the BP score (P < .001).
• Patients with hyperlipidemia experienced reductions in total cholesterol levels (P < .001), low-density lipoprotein cholesterol levels (P < .001), and triglyceride levels (P = .004).
• A1c levels were reduced among patients who utilized nurse practitioner visits (P = .02), and fasting glucose levels were reduced only among those in the highest tertile of utilizing nurse practitioner visits (P = .03).
• BMI decreased significantly only among patients in the highest tertile of remote BP monitoring (P = .02); four of 27 active smokers quit smoking by 12 months.

IN PRACTICE:

“These findings advocate for reframing remote patient monitoring-based hypertension management paradigms, particularly those integrating provider support, as comprehensive care models and highlight key components that merit prioritization,” the authors wrote.

SOURCE:

This study was led by Ethan Chervonski, MD, MPH, of New York University Grossman School of Medicine in New York City. It was published online on August 3, 2025, in the American Journal of Preventive Medicine.

LIMITATIONS:

This retrospective observational study did not establish whether utilization of the intervention caused the improvements in cardiovascular health markers. The 12-month data were available for 40%-61% of all patients for any given marker. The baseline indicators of cardiovascular health were determined by the last value recorded before enrollment.

DISCLOSURES:

This study was supported by grants from the National Institutes of Health/National Institute on Minority Health and Health Disparities and the Health Resources and Services Administration. One author reported being on the board of Equipo Health.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.