Measuring blood pressure by remote patient monitoring for cardiovascular disease management

Remote Patient Monitoring for Cardiovascular Disease

Managing cardiovascular disease (CVD) with remote patient monitoring (RPM) has shown significant improvement in patient outcomes. Data indicate that the use of RPM devices can lead to reductions in blood pressure, predict HF decompensation, and detect arrhythmia early to enable faster interventions. Heart disease affects about 121.5 million adults in the US and is the leading cause of death for this population. Implementing RPM for patients with CVD or as a preventative step prior to a CVD diagnosis can help patients live healthier and longer lives, reducing both hospitalizations and mortality.

Hypertension

As reported by the American Heart Association, RPM with a blood pressure cuff can reduce blood pressure beyond the benefits seen from self-monitoring. Patients have seen improvements in both systolic and diastolic blood pressure during the use of RPM, and this benefit can be increased by regular communication between the patient and a healthcare professional, as well as by titrating antihypertensive medication in line with the readings from RPM, according to research published in the journal Hypertension. A study in Clinical Cardiology showed that 91% of patients following a weekly blood pressure monitoring protocol reached a target BP of less than 135/85 mm Hg in an average of seven weeks on the program.

In addition to being an important method for tracking patients diagnosed with hypertension, RPM can be applied as a preventative method to help keep a patient’s condition from advancing to hypertension. The ease of use and convenience of RPM has also made it a helpful tool for tracking gestational hypertension

Heart Failure

In addition to the portable devices, implantable RPM devices are gaining traction to monitor an expanded list of physiological data points for CVD. A recent study of 141 patients with heart failure analyzed the effects of using either the CardioMEMS™ HF System, a pulmonary artery pressure (PAP) monitor, or HeartLogic™ HF Diagnostic, a multisensor cardiac implantable electronic device (CIED). Implementation of RPM with these devices lowered cardiac-related emergency room visits by 28% and cardiac hospitalizations by 19%. For patients who were hospitalized, the total length of stay was 51% shorter as compared to patients not using RPM.

Other work focused on a single type of RPM device similarly found positive outcomes from implantable devices for monitoring HF patients. A CardioMEMS™ study showed that HF-related hospitalizations were reduced by 57% and overall hospitalizations were lowered 27% for patients using the PAP monitor. Predicting HF decompensation was also shown to be possible from the CIED-based HeartLogic™ index, which can alert a healthcare professional ahead of an HF event.

Atrial Fibrillation

RPM can improve patient outcomes by facilitating early detection of arrhythmia. In one retrospective analysis of over 37,000 patients, RPM with implantable cardioverter defibrillators led to a reduction in both the mortality and 3-year all-cause rehospitalization rate for patients who used RPM relative to those who did not. Similarly, a study of about 270,000 patients with a range of implanted RPM devices found benefits for patients with the RPM devices regardless of device type. Participants in the research had pacemakers, implantable cardioverter defibrillators, or cardiac resynchronization therapy with pacing capability or defibrillation capability. Overall, those with an implanted RPM device had lower all-cause mortality than those without, and greater time spent using the remote monitoring correlated with an increased likelihood of survival.

Beyond the benefits of RPM for individual patient health, the fact that RPM reduces hospital admissions and the length of hospital stays for cardiac events means that RPM can lessen the economic burden of these diseases. In the US, heart disease and stroke account for $214 billion in healthcare costs annually; they also result in a $138 billion loss in productivity. Preventative care in the form of RPM is an important tool to lower these costs to the healthcare system and broader economy.