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Cited by 11Blood Pressure and Hypertension StudiesHealth Systems, Economic Evaluations, Quality of LifeHealth Promotion and Cardiovascular Prevention

The Health and Economic Impact of Expanding Home Blood Pressure Monitoring

Open access
Li, Yan, Zhang, Donglan, Li, Weixin, Chen, Zhuo, Thapa, Janani, Mu, Lan, Zhu, Haidong, Dong, Yanbin +2 more·2023·American Journal of Preventive Medicine
DOI 10.1016/j.amepre.2023.05.010PMC PMC10592599
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Abstract

Introduction Home blood pressure monitoring is more convenient and effective than clinic-based monitoring in diagnosing and managing hypertension. Despite its effectiveness, there is limited evidence of the economic impact of home blood pressure monitoring. This study aims to fill this research gap by assessing the health and economic impact of adopting home blood pressure monitoring among adults with hypertension in the U.S.Methods A previously developed microsimulation model of cardiovascular disease was used to estimate the long-term impact of adopting home blood pressure monitoring versus usual care on myocardial infarction, stroke, and healthcare costs. Data from the 2019 Behavioral Risk Factor Surveillance System and the published literature were used to estimate model parameters. The averted cases of myocardial infarction and stroke and healthcare cost savings were estimated among the U.S. adult population with hypertension and in subpopulations defined by sex, race, ethnicity, and rural/urban area. The simulation analyses were conducted between February and August 2022.Results Compared with usual care, adopting home blood pressure monitoring was estimated to reduce myocardial infarction cases by 4.9% and stroke cases by 3.8% as well as saving an average of $7,794 in healthcare costs per person 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 with non-Hispanic Whites, men, and urban residents.Conclusions Home blood pressure monitoring could substantially reduce the burden of cardiovascular disease and save healthcare costs in the long term, and the benefits could be more pronounced in racial and ethnic minority groups and those living in rural areas. These findings have important implications in expanding home blood pressure monitoring for improving population health and reducing health disparities.

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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 [12]

    The Study Sample section reports improved BP control with home blood pressure monitoring, and the Discussion describes randomized-trial evidence that a monitoring program was cost-effective. But this paper is a microsimulation, not a randomized trial: it projects cardiovascular events and explicitly says it did not conduct a cost-effectiveness analysis. Its trial evidence therefore does not establish the full claim that randomized trials demonstrated fewer cardiovascular events. (LLM, conf=0.88)

    Experimental — accuracy not yet measured

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Authors
Li, Y., Zhang, D., Li, W., Chen, Z., Thapa, J., Mu, L., Zhu, H., Dong, Y., Li, L., & Pagán, J. A.
Affiliations
  • Shanghai Jiao Tong University (CN)
  • NYU Grossman Long Island School of Medicine (US)
  • Icahn School of Medicine at Mount Sinai (US)
  • University of Georgia (US)
  • Augusta University (US)
  • New York University (US)
Corresponding author
  • Li, Yan
  • Zhang, Donglan
ORCID
Venue
American Journal of Preventive Medicine
Publisher
Elsevier BV
Published
2023-11
Volume
65
Issue
5
Pages
775-782
ISSN
0749-3797 (ISSN-L)
DOI
10.1016/j.amepre.2023.05.010
PMC
PMC10592599
OpenAlex
W4376287720
Cited by
11
References
29
Citations by year
2026: 3 · 2025: 5 · 2024: 3
FWCI
2.16
Type
journal article
Language
en
Open access
Licence
Locations
  • American Journal of Preventive Medicine (acceptedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
Funders
  • National Institute on Minority Health and Health Disparities (R01HL141427, R01MD013886)
  • National Institutes of Health
  • National Heart, Lung, and Blood Institute
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 › Public Health, Environmental and Occupational Health › Health Promotion and Cardiovascular Prevention
Keywords
home blood pressure monitoring, hypertension, cardiovascular disease, myocardial infarction, stroke, health care costs, cost reduction, racial and ethnic disparities, rural health, sex differences, microsimulation model
MeSH terms
Adult, Blood Pressure, Ethnicity, Female, Humans, Hypertension, Male, Minority Groups, Myocardial Infarction, Blood Pressure Monitoring, Ambulatory, Stroke

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