Expanding home blood pressure monitoring amongst US adults with hypertension could substantially reduce the burden of heart problems and save healthcare costs in the long run, in keeping with a latest study within the American Journal of Preventive Medicine, published by Elsevier. The outcomes of the study show that expanding home monitoring has the potential to handle pervasive health disparities facing racial and ethnic minorities and rural residents since it would scale back cardiovascular events amongst 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 many first to evaluate the potential health and economic impact of adopting home blood pressure monitoring amongst American adults with hypertension. We found that it facilitates early detection, timely intervention, and prevention of complications, resulting in improved control and higher health outcomes.”

Analyzing data from the 2019 Behavioral Risk Factor Surveillance System (BRFSS), investigators projected that implementing home blood pressure monitoring, versus traditional clinic-based care, could end in a discount 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 in comparison with non-Hispanic Whites, men, and concrete residents. Adopting home blood pressure monitoring in rural areas would result in a possible reduction of 21,278 MI cases per a million people in comparison with 11,012 MI cases per a million people in urban areas. Rural residents are likely to have the next prevalence of hypertension and uncontrolled hypertension than urban residents and sometimes 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 a median of 4.4% per person annual savings and a median of $7,794 in healthcare costs per person over a span of 20 years on this population on account of home blood pressure monitoring adoption and the following reduced heart problems 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 within the US, with significant implications for the event of heart disease and stroke and results in substantial healthcare costs. Traditional clinic monitoring, the common method for BP measurement and hypertension diagnosis, has quite a lot of drawbacks: Patients may not visit clinics often enough to select up the issue, and after they do, accuracy could also be compromised by the “white coat” (high office BP but normal BP on home measurements) or “masked” (normal/high normal BP within the office but elevated at home) effects.

Home blood pressure monitoring eliminates these impediments and provides more comprehensive and accurate data in comparison with sporadic measurements obtained during clinic visits. Yet, the highly effective practice has not been widely adopted within the US due to inadequate health insurance coverage, lack of investment in preventive services, and limited health promotion efforts provided by primary care physicians. Nevertheless, the landscape has modified between 2020 and 2022 when home blood pressure monitoring attracted increasing attention on account of healthcare disruptions attributable to the COVID-19 pandemic.

Co-lead investigator Donglan Zhang, PhD, Associate Professor, Center for Population Health and Health Services Research, Recent York University Long Island School of Medicine, commented, “On condition that almost half of all adults within the US (47%) are affected by hypertension, and considering the persistent health disparities in cardiovascular health, it is rather vital to advocate for the widespread adoption of effective and cost-saving strategies. Home blood pressure monitoring empowers patients to take a more lively role in managing their chronic conditions. Our findings provide compelling evidence for healthcare systems and payers supporting the broader implementation of this intervention.”

Source:

Journal reference:

Li, Y., et al. (2023). The Health and Economic Impact of Expanding Home Blood Pressure Monitoring. American Journal of Preventive Medicine. doi.org/10.1016/j.amepre.2023.05.010.