Development And Application Of Remote Real-time Hypertension Management System

Background:Hypertension is the most important and common risk factor of cardio-cerebrovascular disease.It often coexists with other cardiovascular risk factors,which can damage target organs such as heart,brain and kidney,and ultimately lead to organ failure.Research shows that the risk of stroke and ischemic heart disease is doubled for every 20/10 mmHg increase in blood pressure.Hypertension affects 1.28 billion people worldwide and is expected to reach 1.56 billion in 2025.Hypertension related diseases have long been the first cause of death among urban and rural residents in China.Therefore,the control of hypertension is one of the most critical factors to prevent CVD and reduce medical costs in China.At present,the prevention and treatment effect of hypertension is still not ideal.To explore a new management mode is the key to improve the blood pressure control rate and reduce the economic burden of China’s medical and health system.Objective:In view of the current situation of high prevalence rate,fatality rate and disability rate of hypertension patients,low awareness rate,control rate and standard attainment rate,and heavy public health and economic burden,our research group aims to evaluate the real-time reminder,blood pressure measurement,upload blood pressure data,drug administration reminder,record medication information,provide health education content,and realize interactive communication intervention to control blood pressure through the remote real-time hypertension management system.It also provides real-time hypertension remote training for primary doctors,so as to improve medication compliance and blood pressure control rate of hypertension patients and reduce complications.Methods:According to the current domestic and foreign guidelines and our hospital’s experience in hypertension management,our research group jointly developed the Internet+hypertension management system with iHealth and connected it with Jiu’an intelligent sphygmomanometer,so as to ensure that patients’blood pressure could be uploaded to the doctor’s WEB terminal in real time and then carried out remote hypertension management.A total of 581 patients with hypertension were randomly divided into control group(n=291)and experimental group(n=290).Patients in both groups received the remote real-time hypertension management system developed by our research group to measure and record blood pressure.The control group routinely measured blood pressure according to the personal exercise abstract,but did not communicate with the doctor remotely through the system,and visited the outpatient clinic regularly to adjust antihypertensive drugs.The experimental group applied the system to measure and record blood pressure.Meanwhile,through the system,patients could communicate with doctors in real time and interact with them to adjust antihypertensive drugs at any time.The medical staff can also take the initiative to remotely monitor the patient’s blood pressure through this system,and actively intervene online,including diet guidance,exercise,measurement reminder,medication guidance,etc.Results:There were no significant differences between the two groups in gender composition,age,body mass index,past history,personal history,blood pressure classification,target organ damage,diabetes mellitus,antihypertensive drug type and other baseline data(P>0.05).At 3,6,9 and 12 months of follow-up,the blood pressure compliance rate of patients in the remote interactive intervention group was significantly increased,while the systolic blood pressure,diastolic blood pressure and pulse pressure difference were well controlled,and the medication compliance of the experimental group was better,and the drug types were significantly increased,with statistical significance(P<0.05).Conclusions:The remote hypertension management system developed by our research group can be used smoothly.By using this remote hypertension management system with intelligent wearable devices,medical staff can obviously improve the medication compliance of hypertension patients,improve the blood pressure level of hypertension patients after 3,6,9 and 12 months of follow-up,and improve the rate of blood pressure reaching the standard,which provides new digital medical ideas for hypertension prevention and treatment.