Telemonitoring of 24-Hour Blood Pressure in Local Pharmacies and Blood Pressure Control in the Community: The Templar Project

TEMPLAR (TEleMonitoring of blood Pressure in Local phARmacies) Project Group

Research output: Contribution to journalArticle

Abstract

BACKGROUND: The analysis of ambulatory blood pressure monitorings (ABPMs) performed in 639 Italian pharmacies in the context of a telehealth-based service allowed to evaluate the level of blood pressure (BP) control in the community. METHODS: Twenty-four-hour ABPMs were performed by a clinically validated, automated, upper-arm BP monitor. Recordings were uploaded on a certified web-based telemedicine platform (www.tholomeus.net) and remote medical reporting provided. In each subject, an automatic BP measurement was obtained in the pharmacy and clinical information collected before starting the ABPM. RESULTS: A total of 20,773 subjects (mean age 57 ± 15 years; 54% females; 28% receiving antihypertensive medications, 31% with any cardiovascular [CV] risk factor) provided valid ABPMs. BP control was poor, but better in ambulatory conditions (24-hour BP <130/80 mm Hg 54% vs. pharmacy BP < 140/90 mm Hg 43%; P < 0.0001) and in drug-treated subjects. Sustained normotension was reported in only 28% subjects. Isolated nocturnal hypertension (16%; nighttime BP ≥120/70 mm Hg with normal daytime BP) was more common (P < 0.0001) than isolated daytime hypertension (9%; daytime BP ≥ 135/85 mm Hg with normal nighttime BP). Sustained hypertension (43%) was more common in younger males at the lowest CV risk, with daytime hypertension. White-coat hypertension (14%) was more common in females. Masked hypertension was not uncommon (15%) and more often observed in older males with an elevated nocturnal BP. CONCLUSIONS: A telemedicine-based service provided to community pharmacies may facilitate access to ABPM, thus favoring a more accurate hypertension screening and detection. It may also help describe the occurrence of different 24-hour BP phenotypes and personalize the physician's intervention.

Original languageEnglish
Pages (from-to)629-639
Number of pages11
JournalAmerican Journal of Hypertension
Volume32
Issue number7
DOIs
Publication statusPublished - Jan 1 2019

Fingerprint

Pharmacies
Blood Pressure
Ambulatory Blood Pressure Monitoring
Telemedicine
Hypertension
Masked Hypertension
White Coat Hypertension
Blood Pressure Monitors
Antihypertensive Agents
Arm
Physicians
Phenotype

Keywords

  • ambulatory blood pressure monitoring
  • blood pressure
  • blood pressure telemonitoring
  • hypertension
  • pharmacy
  • telehealth
  • telemedicine

ASJC Scopus subject areas

  • Internal Medicine

Cite this

Telemonitoring of 24-Hour Blood Pressure in Local Pharmacies and Blood Pressure Control in the Community : The Templar Project. / TEMPLAR (TEleMonitoring of blood Pressure in Local phARmacies) Project Group.

In: American Journal of Hypertension, Vol. 32, No. 7, 01.01.2019, p. 629-639.

Research output: Contribution to journalArticle

TEMPLAR (TEleMonitoring of blood Pressure in Local phARmacies) Project Group. / Telemonitoring of 24-Hour Blood Pressure in Local Pharmacies and Blood Pressure Control in the Community : The Templar Project. In: American Journal of Hypertension. 2019 ; Vol. 32, No. 7. pp. 629-639.
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abstract = "BACKGROUND: The analysis of ambulatory blood pressure monitorings (ABPMs) performed in 639 Italian pharmacies in the context of a telehealth-based service allowed to evaluate the level of blood pressure (BP) control in the community. METHODS: Twenty-four-hour ABPMs were performed by a clinically validated, automated, upper-arm BP monitor. Recordings were uploaded on a certified web-based telemedicine platform (www.tholomeus.net) and remote medical reporting provided. In each subject, an automatic BP measurement was obtained in the pharmacy and clinical information collected before starting the ABPM. RESULTS: A total of 20,773 subjects (mean age 57 ± 15 years; 54{\%} females; 28{\%} receiving antihypertensive medications, 31{\%} with any cardiovascular [CV] risk factor) provided valid ABPMs. BP control was poor, but better in ambulatory conditions (24-hour BP <130/80 mm Hg 54{\%} vs. pharmacy BP < 140/90 mm Hg 43{\%}; P < 0.0001) and in drug-treated subjects. Sustained normotension was reported in only 28{\%} subjects. Isolated nocturnal hypertension (16{\%}; nighttime BP ≥120/70 mm Hg with normal daytime BP) was more common (P < 0.0001) than isolated daytime hypertension (9{\%}; daytime BP ≥ 135/85 mm Hg with normal nighttime BP). Sustained hypertension (43{\%}) was more common in younger males at the lowest CV risk, with daytime hypertension. White-coat hypertension (14{\%}) was more common in females. Masked hypertension was not uncommon (15{\%}) and more often observed in older males with an elevated nocturnal BP. CONCLUSIONS: A telemedicine-based service provided to community pharmacies may facilitate access to ABPM, thus favoring a more accurate hypertension screening and detection. It may also help describe the occurrence of different 24-hour BP phenotypes and personalize the physician's intervention.",
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