Smartphone apps may be the next best thing for managing high blood pressure, based on results of a six-week study that tested a remote blood pressure monitoring system in patients with diabetes and hypertension. Results will be presented on March 17 at the American College of Cardiology’s 68th Annual Scientific Session and link the at-home tool to significant reductions in blood pressure.
Conducted by researchers at the Duke University School of Medicine, this study tested a smartphone app developed by Livongo, a company based in Mountain View, CA. The app combines technology, data science and coaching to help its members with diabetes and other chronic diseases better manage their conditions.
The goal of the recent study was to see whether this app helps patients with hypertension and diabetes lower their blood pressure. According to authors, this is a very high-risk population, as diabetes and high blood pressure are both major risk factors for heart disease and life-threatening heart events. When diabetes and high blood pressure are combined, risk for complications is even higher.
It’s estimated that 1 in 2 U.S. adults has high blood pressure and only half have the condition under control.
The good news is that managing diabetes and high blood pressure helps greatly reduce cardiovascular risk. A smartphone app, combined with home monitoring and coaching, may be just what patients need to get their conditions under control.
The recent study included 708 adults with diabetes, most of who had uncontrolled high blood pressure—defined as having a blood pressure greater than 130/80 mmHg.
All participants received a blood pressure monitor and cuff that connected wirelessly with Livongo’s smartphone app. When participants measured their blood pressure with their smartphones nearby (which they did an average of four times a week), the readings were automatically sent to Livongo’s computer servers.
After each reading, participants could open the app to review the results and get tips on managing their blood pressure. For example, the app can remind participants to take their medications, follow a healthy eating pattern, be more physically active and drop a few pounds in weight. The app also allowed participants to compare their blood pressure readings over time, schedule a call with a health coach, and share their results with family members, friends or health care providers.
After six weeks of using the app, participants’ systolic blood pressure (the top number in a blood pressure reading) declined by an average of 5.4 mmHg. Diastolic pressure (the bottom number) declined by 3.5 mmHg on average, compared with their levels at study entry, said Bimal R. Shah, MD, chief medical officer of Livongo, assistant consulting professor at Duke University School of Medicine, and lead author of the study.
This translated to 41% of participants having a blood pressure above 130/80 mmHg after six weeks, down from 63% at the start of the study.
While additional clinical trials are needed to validate results, experts are encouraged by findings.
“We have shown in this pilot study that, in a population with both diabetes and high blood pressure, six weeks of remote blood pressure monitoring—accompanied by education about high blood pressure management and access to health coaches—can significantly improve blood pressure control,” Shah said. “The improvement is comparable to what doctors would expect to see if a patient had started taking a low to moderate dose of a high blood pressure medication.”
Authors are hopeful that continued use of these tools could have a meaningful impact in patients over time. “This was a short study to demonstrate the proof of concept,” Shah said. “With longer follow-up and further coaching, we expect that more participants will see durable blood pressure reductions.”