# Associations between remote patient monitoring and uncontrolled blood pressure among patients diagnosed with hypertension: Exploring variations by race/ethnicity

## TL;DR

This study explores how remote patient monitoring affects blood pressure control in different racial/ethnic groups with hypertension.

## Contribution

The study reveals how RPM utilization and its impact on blood pressure control vary by race/ethnicity.

## Key findings

- Non-Hispanic Black and Hispanic patients had higher rates of uncontrolled blood pressure compared to non-Hispanic White patients.
- Patients with low RPM engagement had significantly higher odds of uncontrolled blood pressure across all racial/ethnic groups.
- Disparities in RPM use and outcomes mirror broader inequities in digital health access and hypertension management.

## Abstract

Hypertension (HTN) is a critical public health concern that disproportionately impacts racial/ethnic minorities. The recent COVID-19 pandemic spurred rapid adoption of virtual HTN treatment programs such as remote patient monitoring programs (RPM), including among minority populations. However, it is unclear how utilization patterns differ across racial/ethnic groups and what the implications are for HTN outcomes.

The present study examines whether the association between RPM utilization and uncontrolled BP differs by race/ethnicity among hypertensive patients enrolled in an RPM program.

This study includes an urban sample of HTN patients who were 18 ≥ years old who have been in their RPM programs for three consecutive months or longer. Our primary exposure measures are three widely used dichotomized RPM engagement metrics and uncontrolled BP outcomes were dichotomized as BP ≥ 140/90 and ≥ 130/80. We tested for effect modification by race/ethnicity across RPM utilization variables using multivariable logistic regression models.

Of 2920 participants, 59% were females, 37% were ≥ 65 years old, and Hispanic patients were the most represented race/ethnicity group (39%). Percentage-uncontrolled was 25% non-Hispanic Black, 21% Hispanic, and 20% among non-Hispanic White patients. Compared to non-Hispanic White patients with high RPM utilization, patients with no BP transmission had higher odds of uncontrolled BP: White (OR=1.72; 95% CI: 1.07–2.75), Black (OR=2.11; 95% CI: 1.32–3.39), and Other race (OR=2.36; 95% CI: 1.41–3.96). Similar patterns were observed for low clinician interactions and low portal use.

Disparities in RPM utilization and BP outcomes in our study parallel reported inequities in digital technology utilization and uncontrolled BP in the U.S. Future studies should aim to understand how utilization trends among various vulnerable populations influence HTN outcomes. Such findings may help inform efforts aimed at streamlining access and utilization of RPM to reduce utilization disparities and promote better BP control.