Economic Evaluation of Blood Pressure Monitoring Techniques in Patients With Hypertension: A Systematic Review
Open accessAbstract
Importance: Blood pressure monitoring is critical to the timely diagnosis and treatment of hypertension. At-home self-monitoring techniques are highly effective in managing high blood pressure; however, evidence regarding the cost-effectiveness of at-home self-monitoring compared with traditional monitoring in clinical settings remains unclear. Objective: To identify and synthesize published research examining the cost-effectiveness of at-home blood pressure self-monitoring relative to monitoring in a clinical setting among patients with hypertension. Evidence Review: A systematic literature search of 5 databases (PubMed, MEDLINE, Embase, EconLit, and CINAHL) followed by a backward citation search was conducted in September 2022. Full-text, peer-reviewed articles in English including patients with high blood pressure (systolic blood pressure ≥130 mm Hg and diastolic blood pressure ≥80 mm Hg) at baseline were included. Data from studies comparing at-home self-monitoring with clinical-setting monitoring alternatives were extracted, and the outcomes of interest included incremental cost-effectiveness and cost-utility ratios. Non–peer-reviewed studies or studies with pregnant women and children were excluded. To ensure accuracy and reliability, 2 authors independently evaluated all articles for eligibility and extracted relevant data from the selected articles. Findings: Of 1607 articles identified from 5 databases, 16 studies met the inclusion criteria. Most studies were conducted in the US (6 [40%]) and in the UK (6 [40%]), and almost all studies (14 [90%]) used a health care insurance system perspective to determine costs. Nearly half the studies used quality-adjusted life-years gained and cost per 1–mm Hg reduction in blood pressure as outcomes. Overall, at-home blood pressure monitoring (HBPM) was found to be more cost-effective than monitoring in a clinical setting, particularly over a minimum 10-year time horizon. Among studies comparing HBPM alone vs 24-hour ambulatory blood pressure monitoring (ABPM) or HBPM combined with additional support or team-based care, the latter were found to be more cost-effective. Conclusions and Relevance: In this systematic review, at-home blood pressure self-monitoring, particularly using automatic 24-hour continuous blood pressure measurements or combined with additional support or team-based care, demonstrated the potential to be cost-effective long-term compared with care in the physical clinical setting and could thus be prioritized for patients with hypertension from a cost-effectiveness standpoint.
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Several randomized controlled trials have demonstrated that RPM-HTN can be effective and cost-effective in managing hypertension, enhancing BP control, and mitigating cardiovascular disease events.
“Several randomized controlled trials have demonstrated that RPM-HTN can be effective and cost-effective in managing hypertension, enhancing BP control, and mitigating cardiovascular disease events.7–12”
From Program cost and return on investment analysis of remote patient monitoring for hypertension management in the cardiology department of a large healthcare system (2026) · cites this paper as [8]
The Results (Cost-Effectiveness Outcomes; page unavailable) report that 9 of 16 studies found at-home BP monitoring cost-effective compared with usual care, and the Main Study Characteristics include seven trials. The paper does not report that randomized trials demonstrated fewer cardiovascular disease events; its Conclusions describe long-term cost-effectiveness as a potential finding, not a uniform trial result. (LLM, conf=0.87)
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Zhang, D. S., Millet, L., Bellows, B. K., Lee, S., & Mann, D. (2026) · Journal of Telemedicine and Telecare · doi:10.1177/1357633x251403059
- Authors
- Hayek, M. A., Giannouchos, T., Lawley, M., & Kum, H.-C.
- Affiliations
- Texas A&M University (US)
- University of Alabama at Birmingham (US)
- Corresponding author
- Giannouchos, Theodoros
- Venue
- JAMA Network Open
- Publisher
- American Medical Association (AMA)
- Published
- 2023-11-21
- Volume
- 6
- Issue
- 11
- Pages
- e2344372
- ISSN
- 2574-3805 (ISSN-L)
- PMC
- PMC10663963
- OpenAlex
- W4388860552
- Cited by
- 32
- References
- 42
- Citations by year
- 2026: 11 · 2025: 11 · 2024: 10
- FWCI
- 1.67
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- cc-by
- Locations
- JAMA Network Open (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Blood Pressure and Hypertension Studies
- Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Health Systems, Economic Evaluations, Quality of Life
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Health and Disease Prevention
- Keywords
- hypertension, self-measured blood pressure, home blood pressure monitoring, cost-effectiveness, ambulatory blood pressure monitoring, team-based care, quality-adjusted life years, health care costs, antihypertensive therapy
- MeSH terms
- Blood Pressure, Child, Cost-Benefit Analysis, Female, Humans, Hypertension, Pregnancy, Reproducibility of Results, Blood Pressure Monitoring, Ambulatory
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