Home blood pressure monitoring saves lives, cuts costs, and reduces
healthcare disparities

Date:
July 13, 2023
Source:
Elsevier
Summary:
Expanding home blood pressure monitoring among US adults with
hypertension could substantially reduce the burden of cardiovascular
disease and save healthcare costs in the long term, according
to a new study. The results of the study show that expanding home
monitoring has the potential to address pervasive health disparities
facing racial and ethnic minorities and rural residents because
it would reduce cardiovascular events among US adults.


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FULL STORY ========================================================================== Expanding home blood pressure monitoring among US adults with
hypertension could substantially reduce the burden of cardiovascular
disease and save healthcare costs in the long term, according to a
new study in the American Journal of Preventive Medicine, published by Elsevier. The results of the study show that expanding home monitoring
has the potential to address pervasive health disparities facing racial
and ethnic minorities and rural residents because it would reduce cardiovascular events among US adults.

Co-lead investigator Yan Li, PhD, Professor, School of Public Health,
Shanghai Jiao Tong University School of Medicine, explained, "Our
study is among the first to assess the potential health and economic
impact of adopting home blood pressure monitoring among American adults
with hypertension. We found that it facilitates early detection, timely intervention, and prevention of complications, leading to improved control
and better health outcomes." Analyzing data from the 2019 Behavioral
Risk Factor Surveillance System (BRFSS), investigators projected that implementing home blood pressure monitoring, as opposed to traditional clinic-based care, could result in a reduction of myocardial infarction
(MI) cases by 4.9% and stroke cases by 3.8% over 20 years.

Non-Hispanic Blacks, women, and rural residents had more averted
cardiovascular events and greater cost savings related to adopting
home blood pressure monitoring compared to non-Hispanic Whites, men,
and urban residents. Adopting home blood pressure monitoring in rural
areas would lead to a potential reduction of 21,278 MI cases per one
million people compared to 11,012 MI cases per one million people
in urban areas. Rural residents tend to have a higher prevalence of hypertension and uncontrolled hypertension than urban residents and
often face additional barriers in accessing primary care services.

Estimating healthcare cost parameters based on actual healthcare payment
data from the Medical Expenditure Panel Survey (MEPS), researchers
projected an average of 4.4% per person annual savings and an average
of $7,794 in healthcare costs per person over a span of 20 years in
this population due to home blood pressure monitoring adoption and
the subsequent reduced cardiovascular disease cases. Previous economic evaluations of home blood pressure monitoring have primarily focused
on local health systems or conducted short-term, small-scale randomized controlled trials.

Hypertension -- systolic blood pressure (BP) greater than 130 mmHg or a diastolic BP greater than 80 mmHg or being on medication for it -- is a pressing public health challenge in the US, with significant implications
for the development of heart disease and stroke and leads to substantial healthcare costs. Traditional clinic monitoring, the common method for
BP measurement and hypertension diagnosis, has a number of drawbacks:
Patients may not visit clinics often enough to pick up the problem,
and when they do, accuracy may be compromised by the "white coat" (high
office BP but normal BP on home measurements) or "masked" (normal/high
normal BP in the office but elevated at home) effects.

Home blood pressure monitoring eliminates these impediments and provides
more comprehensive and accurate data compared to sporadic measurements
obtained during clinic visits. Yet, the highly effective practice has
not been widely adopted in the US because of inadequate health insurance coverage, lack of investment in preventive services, and limited health promotion efforts provided by primary care physicians. However, the
landscape has changed between 2020 and 2022 when home blood pressure
monitoring attracted increasing attention due to healthcare disruptions
caused by the COVID-19 pandemic.

Co-lead investigator Donglan Zhang, PhD, Associate Professor, Center
for Population Health and Health Services Research, New York University
Long Island School of Medicine, commented, "Given that almost half
of all adults in the US (47%) are affected by high blood pressure, and considering the persistent health disparities in cardiovascular health, it
is very important to advocate for the widespread adoption of effective and cost-saving strategies. Home blood pressure monitoring empowers patients
to take a more active role in managing their chronic conditions. Our
findings provide compelling evidence for healthcare systems and payers supporting the broader implementation of this intervention."
* RELATED_TOPICS
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========================================================================== Journal Reference:
1. Yan Li, Donglan Zhang, Weixin Li, Zhuo Chen, Janani Thapa, Lan Mu,
Haidong Zhu, Yanbin Dong, Lihua Li, Jose' A. Paga'n. The
Health and Economic Impact of Expanding Home Blood Pressure
Monitoring. American Journal of Preventive Medicine, 2023; DOI:
10.1016/j.amepre.2023.05.010 ==========================================================================

Link to news story: https://www.sciencedaily.com/releases/2023/07/230713142003.htm

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