Log in to MyACC
Smartphone Health Monitoring for Blood Pressure Control Among MI Patients
Study Questions:
Can smart technology improve blood pressure (BP) control in patients after myocardial infarction (MI)?
Methods:
This single-center, nonblinded, feasibility clinical trial randomized patients admitted with either ST-segment elevation MI or non–ST-segment acute coronary syndrome to two groups: smart technology or regular care, in a 1:1 fashion. The trial was conducted between May 2016 and December 2018. The smart technology group received four smartphone-compatible devices (weight scale, BP monitor, rhythm monitor, and step counter). In addition, two in-person outpatient clinic visits were replaced by electronic visits. The regular care group received four physical outpatient clinic visits scheduled in the year following the initial event. The primary outcome of interest was BP control. Secondary outcomes included patient satisfaction (general questionnaire and smart technology–specific questionnaire), measurement adherence, all-cause mortality, and hospitalizations for nonfatal adverse cardiac events.
Results:
A total of 200 patients (median age, 59.7 years; 156 men [78%]) were included in the trial. There were no substantial differences in baseline characteristics between the intervention group and the control group including median age and body mass index. Rates of hypertension were similar between groups (40% intervention group vs. 37% control group). After 1 year, 79% of patients in the intervention group had controlled BP versus 76% of patients in the control group (p = 0.64). General satisfaction with care was the same between groups (mean [standard deviation] scores, 82.6 [14.1] vs. 82.0 [15.1]; p = 0.88). The all-cause mortality rate was 2% in both groups (p > 0.99). A total of 20 hospitalizations for nonfatal adverse cardiac events occurred (eight in the intervention group and 12 in the control group). Of all patients, 32% sent in measurements each week, with 63% sending data for >80% of the weeks they participated in the trial; 90.3% of the patients in the intervention group reported being satisfied with the smart technology intervention.
Conclusions:
The investigators concluded that these findings suggest that smart technology yields similar percentages of patients with regulated BP compared with the standard of care. Such an intervention is feasible in clinical practice and is accepted by patients. More research is mandatory to improve patient selection of such an intervention.
Perspective:
This study suggests that smart technology can be helpful in BP management among post-MI patients. However, further studies among other groups including older patients is warranted.
Clinical Topics: Acute Coronary Syndromes, Cardiovascular Care Team, Diabetes and Cardiometabolic Disease, Prevention, Hypertension
Keywords: Acute Coronary Syndrome, Ambulatory Care, Blood Pressure, Blood Pressure Determination, Body Mass Index, Hypertension, Metabolic Syndrome, Mobile Applications, Myocardial Infarction, Patient Satisfaction, Primary Prevention, Standard of Care
< Back to Listings
