App-based blood pressure monitors don’t outperform basic cuffs at controlling hypertension

SAN FRANCISCO — Smartphone apps that connect to sophisticated blood pressure monitors are no more effective than simple at-home cuffs, according to a new study. Researchers at UC San Francisco found almost no significant difference between the readings on the two devices after six months.

Patients who used the standard cuffs reduced their blood pressure by 10.6 millimeters of mercury (mmHg) while people using a smartphone app saw their pressure fall by 10.8 mmHg during the study. There was also no significant difference in patients’ satisfaction with either device.

The researchers say the Bluetooth-enabled phone devices, which provide data visualization, reminders, and other features, can cost around $100 and take a long time to set up without actually being of great benefit to patients. People who want to save money or hassle can manage effectively without them, the team contends.

For the study, the team compared the effectiveness of the two devices at 20 medical centers across the U.S. They randomly sent either the cuffs or the phone-controlled devices to more than 2,000 people with high blood pressure. One-third of the patients were Black or Hispanic.

The researchers did not seek to influence how doctors managed patients or how patients used the devices. Surprisingly, the phone devices were of no great benefit as earlier studies have suggested. Those reports concluded that lots of intensive monitoring, which can be done more easily on a phone device, is better at keeping blood pressure down.

“We think this study is important because it provides practical real-world answers for doctors and patients,” says corresponding author Mark Pletcher, MD, MPH, a UCSF professor of epidemiology and biostatistics, in a media release.

“There have been a lot of studies suggesting that with home monitoring, the more support and handholding you give, the better results you get for blood pressure control. But most of these programs are really hard and expensive to implement,” Pletcher continues. “We thought commercially available technology might help by providing patients with reminders to check their blood pressure, and the ability to visualize and understand the data.”

“There’s a cost issue with the Bluetooth devices, and the time and effort involved in connecting them to a smartphone is really not trivial. As it turns out, there doesn’t appear to be any benefit to any of that,” Pletcher concludes. “What seems to matter is engagement and support from health care providers.”

Study authors note that the racial and ethnic diversity of the study is important because uneven management of hypertension influences the disproportionate rates of cardiovascular disease in Black communities. In patients across all races and ethnicities, the study found that the newer technology did not outperform the older and simpler blood pressure models.

The team is continuing to explore whether technology, especially smartwatches, can help people control their blood pressure. Estimates show that half of American adults have high blood pressure, which can cause heart attacks and strokes. Daily home readings are more accurate than tests taken by a doctor every few months.

The findings are published in the journal JAMA Internal Medicine.

South West News Service writer Gwyn Wright contributed to this report.

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