The effect of home monitoring and telemanagement on blood pressure controlamong African Americans

Hypertension is disproportionately prevalent among African Americans compar ed with other ethnic groups. Furthermore, research demonstrating effective management strategies for this group is limited. The objectives of this stu dy were to determine: (1) compliance with home blood pressure monitoring am ong hypertensive African Americans, and (2) the effectiveness of telemanage ment in blood pressure control within 1-3 months. Participants used a trans telephonic home monitor that transmitted their blood pressure daily via the ir existing telephone lines to a university sewer system. A one-group, pre- post design was used. The sample included 33 African Americans (age 51.5 +/ - 14.3, 70% female) with uncontrolled blood pressures despite pharmacologic al treatment for greater than or equal to 1 year. Interventions were conduc ted over the phone, including patient education and medication titration co ngruent with JNC-VI guidelines. Daily data were transmitted by 88% of the s ample; significant decreases (p less than or equal to 0.001) in mean systol ic (154.1 +/- 16.0 to 141.4 +/- 12.2 mmHg) and diastolic (89.9 +/- 9.6 to 8 3.2 +/- 9.6 mmHg) blood pressures; and 60% (p less than or equal to 0.001) achieved blood pressure control within 1 month. Significant blood pressure improvements (p ( 0.001) were maintained throughout the study. Additionally , disease knowledge was improved (p < 0.002), and some lifestyle modificati ons were demonstrated including mean weight loss (p less than or equal to 0 .02); quality of life, which was rated as 'satisfying' at baseline, did not change. African American patients in this sample were compliant with the r equired home monitoring and blood pressure control in a relatively short ti me. Other beneficial psychosocial and behavioral effects were demonstrated.