Effectiveness of remote monitoring for patients with a high risk of cardiovascular disease: a 12-month matched cohort study in primary care

TL;DR

A study found that remote monitoring helped manage blood pressure and weight in high-risk cardiovascular patients over 12 months.

Contribution

The study introduces a remote monitoring system (CVRM-Box) and evaluates its impact on cardiovascular risk management in primary care.

Findings

Remote monitoring led to significant reductions in blood pressure and weight in home measurements.

The intervention increased antihypertensive medication use and decreased consultation frequency.

Office-measured blood pressure showed no significant change despite home monitoring improvements.

Abstract

This study aimed to evaluate the effect of remote monitoring using the Cardiovascular Risk Management (CVRM)-Box on blood pressure control, weight management, medication prescriptions, and consultation frequency in primary care patients at high risk of cardiovascular disease (CVD).

In this matched cohort study, patients with a > 5% 10-year CVD mortality risk in primary care (2020–2024) were compared to propensity score-matched controls over 12 months. The CVRM-Box included smartphone-connected devices (blood pressure monitor, weighing scale, activity tracker) linked to general practitioner electronic health records.

Compared to controls, the intervention group showed modest reductions in office-measured systolic {−1.1 mmHg [95% confidence interval (CI), −3.7 to −1.5]; P = 0.39} and diastolic blood pressure [−0.04 mmHg (95% CI, −1.6 to 1.5); P = 0.96]. Sensitivity analyses yielded similar results. However, CVRM-Box assessments showed reductions in systolic [−5.5 mmHg (95% CI, −7.6 to −3.3); P < 0.001] and diastolic blood pressure [−3.8 mmHg (95% CI, −5.1 to −2.4); P < 0.001]. The intervention group also experienced greater reductions in weight [−0.9 kg (95% CI, −1.6 to −0.2); P = 0.01] and body mass index [−0.3 kg/m² (95% CI, −0.5 to −0.01); P = 0.007]. Additionally, antihypertensive medication use increased [0.12 (95% CI, 0.06 to 0.23); P = 0.04], while consultation frequency decreased (rate ratio 0.82; P = 0.002).

While office measurements showed no additional blood pressure reduction, CVRM-Box measurements demonstrated significant decreases. The intervention also improved target blood pressure achievement, promoted weight reduction, increased antihypertensive use, and reduced consultation frequency.

Graphical Abstract

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