Implementation of an At-home Blood Pressure Measurement Protocol in a Hypertension Management Clinical Trial During the COVID-19 Pandemic.
Hailey N Miller, Miriam B Berger, Sandy Askew and 5 others
PMID 35467561WHAT IT FOUND
Video-guided at-home blood pressure readings were collected in a hypertension trial using an Omron upper-arm monitor, with a forearm cuff when the upper-arm circumference exceeded 17 inches.
It describes implementation, not proof that it lowers BP.
Key findings
01Nourish used videoconference-guided at-home BP readings with an Omron upper-arm monitor, and a forearm measurement when the upper-arm circumference exceeded 17 inches.
02The protocol required three readings after a five-minute rest, with one-minute rest between readings, and used the average of the second and third readings for baseline and six-month BP analyses.
03The data system flagged low or high BP readings and gave staff instructions for symptoms, follow-up care, and adverse event reporting.
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What it does not show
It is a protocol and implementation report, not a trial outcome report, so it does not show whether remote BP measurement improved blood pressure or DASH adherence. Staff could not fully observe posture during Zoom, especially feet and legs, so some measurement conditions may not have been followed exactly. The remote BP procedure was not verified against clinic-based standards before implementation. The forearm measurement threshold of 17 inches was tied to the Omron BP7100 cuff size, so it may not apply to other devices. Home environments were not standardized, and participants had device errors, unstable internet, or needed assistance with Zoom, leading to retries and lengthy visits. Participants were English-speaking U.S. adults with hypertension who had a smartphone, data plan, and email, so the protocol may not fit patients without those resources.
Declared interests
The authors declared no conflicts of interest.
The easy way to misread this
Do not read this as evidence that remote home BP monitoring lowers BP or is equivalent to clinic measurement. The paper describes a protocol and implementation details, and it says the procedure was not verified against clinic-based standards before implementation.