Remote Cardiovascular Hypertension Program Enhanced Blood Pressure Control During the COVID‐19 Pandemic
Open accessAbstract
Background: The COVID‐19 pandemic disrupted traditional health care; one fallout was a drastic decrease in blood pressure (BP) assessment. We analyzed the pandemic's impact on our existing remote hypertension management program's effectiveness and adaptability. Methods and Results: This retrospective observational analysis evaluated BP control in an entirely remote management program before and during the pandemic. A team of pharmacists, nurse practitioners, physicians, and nonlicensed navigators used an evidence‐based clinical algorithm to optimize hypertensive treatment. The algorithm was adapted during the pandemic to simplify BP control. Overall, 1256 patients (605 enrolled in the 6 months before the pandemic shutdown in March 2020 and 651 in the 6 months after) were a median age of 63 years old, 57% female, and 38.2% non‐White. Among enrolled patients with sustained hypertension, 51.1% reached BP goals. Within this group, rates of achieving goal BP improved to 94.6% during the pandemic from 75.8% prepandemic ( P <0.0001). Mean baseline home BP was 141.7/81.9 mm Hg during the pandemic and 139.8/82.2 prepandemic, and fell ≈16/9 mm Hg in both periods ( P <0.0001). Maintenance during the pandemic was achieved earlier (median 11.8 versus 19.6 weeks, P <0.0001), with more frequent monthly calls (8.2 versus 3.1, P <0.0001) and more monthly home BP recordings per patient (32.4 versus 18.9, P <0.0001), compared with the prepandemic period. Conclusions: A remote clinical management program was successfully adapted and delivered significant improvements in BP control and increased home BP monitoring despite a nationally observed disruption of traditional hypertension care. Such programs have the potential to transform hypertension management and care delivery.
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- Authors
- Lee, S. G., Blood, A. J., Cannon, C. P., Gordon, W. J., Nichols, H., Zelle, D., Scirica, B. M., & Fisher, N. D. L.
- Affiliations
- Brigham and Women's Hospital (US)
- Department of Pharmacy Services Boston MA
- Corresponding author
- Fisher, Naomi D. L.
- ORCID
- Venue
- Journal of the American Heart Association
- Published
- 2023-03-21
- Volume
- 12
- Issue
- 6
- Pages
- e027296-e027296
- ISSN
- 2047-9980 (ISSN-L)
- PMC
- PMC10111523
- OpenAlex
- W4324129289
- Cited by
- 33
- References
- 43
- Citations by year
- 2026: 3 · 2025: 8 · 2024: 16 · 2023: 6
- FWCI
- 8.42
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- cc-by-nc-nd
- Locations
- Journal of the American Heart Association (publishedVersion, cc-by-nc-nd)
- PubMed Central (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- National Heart, Lung, and Blood Institute (T32HL007604)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Telemedicine and Telehealth Implementation
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Blood Pressure and Hypertension Studies
- Health Sciences › Health Professions › General Health Professions › Mobile Health and mHealth Applications
- Keywords
- hypertension, blood pressure control, remote patient care, telemedicine, COVID-19 pandemic, home blood pressure monitoring, clinical algorithms, pharmacist-led care
- MeSH terms
- COVID-19, Blood Pressure, Female, Humans, Hypertension, Male, Middle Aged, Retrospective Studies, Blood Pressure Monitoring, Ambulatory, Pandemics
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Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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