Effects of home telemonitoring and community-based monitoring on blood pressure control in urban African Americans: A pilot study

BACKGROUND: African Americans have a higher prevalence and greater severity of hypertension than do other minorities and whiter. This fact is particularly problematic when one realizes that the rate of control and treatment of hypertension in the US population is Setting worse rather than better. Alternative strategies to promote blood pressure control need to be tested. OBJECTIVES: The purpose of this pilot study was to test the following hypothesis: Persons who participate in nurse-managed home telemonitoring (HT) plus usual care or who participate in nurse-managed community-based monitoring (CBM) plus usual care will have greater improvement in blood pressure from baseline to 3 months' follow-up than will persons who receive usual care only. METHODS: This study used a randomized controlled design; participants were randomly assigned to I of 3 groups that were stratified by use or nonuse of antihypertension medication. One-way analysis of variance (ANOVA) and analysis of covariance (ANCOVA) controlling for age and body weight were used to determine changes in blood pressure from baseline to 3 months. The sample contained 26 African Americans with a mean age of 59 years. RESULTS: Both the HT group and the CBM group had clinically and statistically significant (P < .05) drops in systolic blood pressure (SBP) and diastolic blood pressure (DBP) at 3 months' follow-up, with participants in the HT group demonstrating the greatest improvement (HT: baseline SRP 148.8 +/- 13.8, DBP 90.2 +/- 5.79; 3 months' follow-up S13P 124.1 +/- 13.82, DBP 75.58 +/- 11.4; CBM: baseline SEP 155.25 +/- 17.0141 DBP 89.42 +/- 10.95, 3 months' follow-up SEP 142.3 +/- 12.1, DBP 78.25 +/- 6.86). There was little change in SEP or DBP at 3 months' follow-up in the usual care only group. CONCLUSION: These are important pilot results, which if replicated in a larger sample will significantly I improve care for urban African Americans with hypertension.