E-Health in Hypertension Management: an Insight into the Current and Future Role of Blood Pressure Telemonitoring

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BLOOD PRESSURE MONITORING AND MANAGEMENT (J COCKCROFT, SECTION EDITOR)

E-Health in Hypertension Management: an Insight into the Current and Future Role of Blood Pressure Telemonitoring Stefano Omboni 1,2

&

Edoardo Panzeri 1 & Luca Campolo 1

# Springer Science+Business Media, LLC, part of Springer Nature 2020

Abstract Purpose of Review Out-of-office blood pressure (BP) monitoring techniques, including home and ambulatory BP monitoring, are currently recommended by hypertension guidelines worldwide to confirm the diagnosis of hypertension and to monitor the appropriateness of treatment. However, such techniques are not always effectively implemented or timely available in the routine clinical practice. In recent years, the widespread availability of e-health solutions has stimulated the development of blood pressure telemonitoring (BPT) systems, which allow remote BP tracking and tighter and more efficient monitoring of patients’ health status. Recent Findings There is currently strong evidence that BPT may be of benefit for hypertension screening and diagnosis and for improving hypertension management. The advantage is more significant when BPT is coupled with multimodal interventions involving a physician, a nurse or pharmacist, and including education on lifestyle and risk factors and drug management. Several randomized controlled studies documented enhanced hypertension management and improved BP control of hypertensive patients through BPT. Potential additional effects of BPT are represented by improved compliance to treatment, intensification, and optimization of drug use, improved quality of life, reduction in risk of developing cardiovascular complications, and costsaving. Applications based on m-health and making use of wearables or smartwatches integrated with machine learning models are particularly promising for the future development of efficient BPT solutions, and they will provide remarkable support decision tools for doctors. Summary BPT and telehealth will soon disrupt hypertension management. However, which approach will be the most effective and whether it will be sustainable in the long-term still need to be elucidated. Keywords E-health . Blood pressure telemonitoring . Hypertension . Telemedicine . M-health . Machine learning

Introduction In recent years, the use of out-of-office blood pressure (BP) monitoring has seen a rapid and substantial diffusion worldwide, with a high level of acceptability among doctors and their This article is part of the Topical Collection on Blood Pressure Monitoring and Management * Stefano Omboni [email protected] 1

Clinical Research Unit, Italian Institute of Telemedicine, Varese, Italy

2

Scientific Research Department of Cardiology, Science and Technology Park for Biomedicine, Sechenov First Moscow State Medical University, Moscow, Russian Federation

patients. Current guidelines now strongly recommend the use of ambulatory blood pressure monitoring (ABPM) and home blood pressure monitoring (HBPM) to confirm the diagnosis of hypertension and t