Online Checkups Control Blood Pressure
Doctor-Patient Communication via Internet Helps Patients Reach Treatment Goals
March 31, 2009 (Orlando, Fla.) -- Using the Internet to stay in touch with your doctor between checkups can help you control blood pressure, a study shows.
"Internet-based telemedicine systems allow patients to report blood pressure readings to their doctors and receive feedback as to how close they are to reaching treatment goals," says study researcher Alfred Bove, MD. Bove is incoming president of the American College of Cardiology (ACC) and emeritus professor of medicine at Temple University in Philadelphia.
"If you have a [borderline high] blood pressure reading, a lot of doctors will say, 'That's not so bad. Let's wait three months and see what it is next time you come,'" Bove says. "But with the Internet, patients and their doctors are continuously looking at the data. They act much more quickly."
"This is the future of chronic disease management," he tells WebMD.
The new study, presented at the ACC annual meeting, involved 388 men and women. They all had a 10% or higher chance of developing heart disease over the next 10 years based on a traditional risk-assessment tool that takes into account age, cholesterol, blood pressure, the presence of diabetes, and smoking status.
Participants were randomly assigned to a care plan that involved office visits with a nurse every four months or to office visits plus the telemedicine intervention.
In the telemedicine group, participants monitored their weight, exercise, and blood pressure at home. Then, they used to Internet to communicate the data to their doctors, who decided whether to adjust their medication, Bove says.
"Subjects were sending us data about six times a month, so they remained engaged in the process," he says.
After one year, systolic blood pressure dropped significantly in both groups, from an average of 146 to 137 points in the office-visits-only group and to 134 points in the telemedicine group. Diastolic blood pressure dropped from 82 points to 78 points in the office-visits-only group and 77 points in the telemedicine group.
In patients with intermediate hypertension -- systolic readings of 140 to 160 points at the start of the study -- blood pressure dropped significantly more in the group using the Internet reporting system than in the office visits group.
Other improvements in heart health were seen as well. Total cholesterol levels dropped from 203 to 193 milligrams per deciliter in the office visit group and from 199 to 190 milligrams per deciliter in the Internet group. LDL "bad" cholesterol levels went from 121 to 114 milligrams per deciliter in the office visit group and from 120 to 114 milligrams per deciliter in the telemedicine group.
"Paying attention clearly works, whether it's through nurse management or using continuous Internet self-reporting," Bove says. "However, telemedicine seems to provide an extra incentive to improve health and could prove to be a more cost-effective strategy to help reduce cardiovascular risks."
Daniel Jones, MD, past president of the American Heart Association and dean of the University of Mississippi School of Medicine, says, "This is one of several studies demonstrating that the combination of some form of Web-based technology plus human intervention is effective in lowering blood pressure."
A number of health sites, including that of the heart association, offer tools that allow patients to monitor their heart disease risk factors, including blood pressure, Jones notes.