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   PID: hpt/lnx 1.9.0-cur 2019-01-08   
   TID: hpt/lnx 1.9.0-cur 2019-01-08   
    Home blood pressure monitoring saves lives, cuts costs, and reduces   
   healthcare disparities    
      
     Date:   
         July 13, 2023   
     Source:   
         Elsevier   
     Summary:   
         Expanding home blood pressure monitoring among US adults with   
         hypertension could substantially reduce the burden of cardiovascular   
         disease and save healthcare costs in the long term, according   
         to a new study. The results of the study show that expanding home   
         monitoring has the potential to address pervasive health disparities   
         facing racial and ethnic minorities and rural residents because   
         it would reduce cardiovascular events among US adults.   
      
      
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   Expanding home blood pressure monitoring among US adults with   
   hypertension could substantially reduce the burden of cardiovascular   
   disease and save healthcare costs in the long term, according to a   
   new study in the American Journal of Preventive Medicine, published by   
   Elsevier. The results of the study show that expanding home monitoring   
   has the potential to address pervasive health disparities facing racial   
   and ethnic minorities and rural residents because it would reduce   
   cardiovascular events among US adults.   
      
   Co-lead investigator Yan Li, PhD, Professor, School of Public Health,   
   Shanghai Jiao Tong University School of Medicine, explained, "Our   
   study is among the first to assess the potential health and economic   
   impact of adopting home blood pressure monitoring among American adults   
   with hypertension. We found that it facilitates early detection, timely   
   intervention, and prevention of complications, leading to improved control   
   and better health outcomes."  Analyzing data from the 2019 Behavioral   
   Risk Factor Surveillance System (BRFSS), investigators projected that   
   implementing home blood pressure monitoring, as opposed to traditional   
   clinic-based care, could result in a reduction of myocardial infarction   
   (MI) cases by 4.9% and stroke cases by 3.8% over 20 years.   
      
   Non-Hispanic Blacks, women, and rural residents had more averted   
   cardiovascular events and greater cost savings related to adopting   
   home blood pressure monitoring compared to non-Hispanic Whites, men,   
   and urban residents. Adopting home blood pressure monitoring in rural   
   areas would lead to a potential reduction of 21,278 MI cases per one   
   million people compared to 11,012 MI cases per one million people   
   in urban areas. Rural residents tend to have a higher prevalence of   
   hypertension and uncontrolled hypertension than urban residents and   
   often face additional barriers in accessing primary care services.   
      
   Estimating healthcare cost parameters based on actual healthcare payment   
   data from the Medical Expenditure Panel Survey (MEPS), researchers   
   projected an average of 4.4% per person annual savings and an average   
   of $7,794 in healthcare costs per person over a span of 20 years in   
   this population due to home blood pressure monitoring adoption and   
   the subsequent reduced cardiovascular disease cases. Previous economic   
   evaluations of home blood pressure monitoring have primarily focused   
   on local health systems or conducted short-term, small-scale randomized   
   controlled trials.   
      
   Hypertension -- systolic blood pressure (BP) greater than 130 mmHg or a   
   diastolic BP greater than 80 mmHg or being on medication for it -- is a   
   pressing public health challenge in the US, with significant implications   
   for the development of heart disease and stroke and leads to substantial   
   healthcare costs. Traditional clinic monitoring, the common method for   
   BP measurement and hypertension diagnosis, has a number of drawbacks:   
   Patients may not visit clinics often enough to pick up the problem,   
   and when they do, accuracy may be compromised by the "white coat" (high   
   office BP but normal BP on home measurements) or "masked" (normal/high   
   normal BP in the office but elevated at home) effects.   
      
   Home blood pressure monitoring eliminates these impediments and provides   
   more comprehensive and accurate data compared to sporadic measurements   
   obtained during clinic visits. Yet, the highly effective practice has   
   not been widely adopted in the US because of inadequate health insurance   
   coverage, lack of investment in preventive services, and limited health   
   promotion efforts provided by primary care physicians. However, the   
   landscape has changed between 2020 and 2022 when home blood pressure   
   monitoring attracted increasing attention due to healthcare disruptions   
   caused by the COVID-19 pandemic.   
      
   Co-lead investigator Donglan Zhang, PhD, Associate Professor, Center   
   for Population Health and Health Services Research, New York University   
   Long Island School of Medicine, commented, "Given that almost half   
   of all adults in the US (47%) are affected by high blood pressure, and   
   considering the persistent health disparities in cardiovascular health, it   
   is very important to advocate for the widespread adoption of effective and   
   cost-saving strategies. Home blood pressure monitoring empowers patients   
   to take a more active role in managing their chronic conditions. Our   
   findings provide compelling evidence for healthcare systems and payers   
   supporting the broader implementation of this intervention."   
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   Materials provided by Elsevier. Note: Content may be edited for style   
   and length.   
      
      
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   Journal Reference:   
      1. Yan Li, Donglan Zhang, Weixin Li, Zhuo Chen, Janani Thapa, Lan Mu,   
         Haidong Zhu, Yanbin Dong, Lihua Li, Jose' A. Paga'n. The   
         Health and Economic Impact of Expanding Home Blood Pressure   
         Monitoring. American Journal of Preventive Medicine, 2023; DOI:   
         10.1016/j.amepre.2023.05.010   
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   Link to news story:   
   https://www.sciencedaily.com/releases/2023/07/230713142003.htm   
      
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