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Going Online to Draw the Line on High Blood Pressure
Date:6/24/2008

lood pressure monitors.

Members of one group in the study received the Web-based training and home monitors and were told to report their readings to their physicians. Another group received the training and monitors, but was instructed to report the readings to pharmacists who had been trained in using "stepped" medication measures for managing high blood pressure. Both home monitoring groups were told to take their blood pressure readings at least twice a week, and to take two measurements each time. The goal was to keep blood pressure readings below 135/85 mm/Hg.

Members of a third group -- the usual care group -- were told to work with their physicians on managing their high blood pressure, but were given no further instruction or home monitors.

The study included almost 800 patients between the ages of 25 and 75, who were randomly assigned to one of the three groups. Most completed one year of follow-up.

In the usual care group, 31 percent achieved blood pressure control of less than 140/90 mm/Hg, while in the home monitoring group, 36 percent achieved control. But the group with the Web-based pharmacist care fared best, with 56 percent achieving blood pressure control.

And, Green said, those who had the highest blood pressure readings were the most improved with the addition of pharmacist care. She said the reason behind the improvement was simply that medication doses were quickly changed or new medications added by the pharmacists to bring blood pressure under control.

"The feedback loop was closed much more quickly here," said Dr. Eric Peterson, a professor of medicine at the Duke Clinical Research Institute in Durham, N.C. "If you have to bring a patient in to change their medications, you don't want to make them come in too often, so it's possible months will go by before changes are made.

"What we have to do is figure out how to integrate new technologies into the current s
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