Background: To determine whether a pharmacist-led, Heart360-enabled, home blood pressure monitoring (HBPM) intervention improves blood pressure (BP) control compared with usual care (UC).
Methods And Results: This randomized, controlled trial was conducted in 10 Kaiser Permanente Colorado clinics. Overall, 348 patients with BP above recommended levels were randomized to the HBPM (n=175) or UC (n=173) groups. There were no statistically significant differences in baseline characteristics between the groups; however, there was a trend toward a higher baseline BP for the HBPM group compared with the UC group (148.8 versus 145.5 mm Hg for systolic BP; 89.6 versus 88.0 mm Hg for diastolic BP). At 6 months, the proportion of patients achieving BP goal was significantly higher in the HBPM group (54.1%) than in the UC group (35.4%; P<0.001). Compared with the UC group, the HBPM group experienced a -12.4-mm Hg larger (95% confidence interval, -16.3 to -8.6) reduction in systolic BP and a -5.7-mm Hg larger (95% confidence interval, -7.8 to -3.6) reduction in diastolic BP. The impact of the intervention on BP reduction was even larger for the subgroup of patients with diabetes mellitus or chronic kidney disease. The HBPM group had more e-mail and telephone contacts and greater medication regimen intensification. The proportion of patients reporting high satisfaction with hypertension care was significantly greater in the HBPM group (58%) than in the UC group (42%), P<0.001.
Conclusions: A pharmacist-led, Heart360-supported, home BP monitoring intervention led to greater BP reductions, superior BP control, and higher patient satisfaction than UC.
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http://dx.doi.org/10.1161/CIRCOUTCOMES.112.968172 | DOI Listing |
Basic Clin Pharmacol Toxicol
February 2025
Department of Biomedicine, Aarhus University, Aarhus, Denmark.
The media-lumen diameter ratio of small arteries is increased in hypertension, diabetes and obesity. It is likely that both shear stress on the endothelial cells, transmural pressure and smooth muscle cell tone are important for the altered vascular structure. However, the precise interaction and importance of these factors are incompletely understood.
View Article and Find Full Text PDFBasic Clin Pharmacol Toxicol
February 2025
Fluids Barriers CNS
January 2025
Department of Neurosurgery, Osaka Medical and Pharmaceutical University, Takatsuki, Osaka, Japan.
Background: Cerebral autoregulation is a robust regulatory mechanism that stabilizes cerebral blood flow in response to reduced blood pressure, thereby preventing cerebral ischaemia. Scientists have long believed that cerebral autoregulation also stabilizes cerebral blood flow against increases in intracranial pressure, which is another component that determines cerebral perfusion pressure. However, this idea was inconsistent with the complex pathogenesis of normal pressure hydrocephalus, which includes components of chronic cerebral ischaemia due to mild increases in intracranial pressure.
View Article and Find Full Text PDFArch Public Health
January 2025
Department of Pharmacy, Fujian Maternity and Child Health Hospital College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, 18 Daoshan Road, Fuzhou, 350001, China.
Background: Our understanding of the global burden distribution of inflammatory cardiomyopathy and myocarditis is very limited.
Objective: To comprehensively assess the global burden distribution and attributable risk factors of inflammatory cardiomyopathy and myocarditis from 1990 to 2019.
Methods: We extracted the data on death, disability-adjusted life years (DALY), and age-standardized rate (ASR) of inflammatory cardiomyopathy and myocarditis from the 2019 Global Burden of Disease (GBD) study, including the comprehensive data and the data classified by age/sex.
Respir Res
January 2025
Department of Pulmonary Medicine, Zhongshan Hospital, Fudan University, Shanghai, 200032, China.
Background: Obstructive sleep apnea (OSA) is frequently associated with increased incidence and mortality of pulmonary hypertension (PH). The immune response contributes to pulmonary artery remodeling and OSA-related diseases. The immunologic factors linked to OSA-induced PH are not well understood.
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