Home BP telemonitoring plus nurse case management improves hypertension in low-income stroke survivors

Black and Hispanic stroke survivors have high rates of recurrent stroke and uncontrolled hypertension in the US. But, by adding nurse case managers (NCM) to home BP telemonitoring (HBTM), NYU Langone Health researchers found that both groups achieved a significantly lower BP than those who didn't have NCMs.

About the study

• Investigators included 450 predominantly low-income Black and Hispanic adult stroke survivors with uncontrolled hypertension and significant comorbidity from NYC health systems. Most participants were male (56%), and 31% had ≥3 comorbid conditions. Nearly three in four participants had an annual household income <$25,000/y.
• Participants were randomly assigned to receive either HBPTM alone (12 home BP measurements/week for 12 months, with results transmitted to a clinician; n = 226) or NCM plus HBPTM, which included the addition of 20 counseling calls over 12 months (n = 224). Primary outcomes were change in SBP at 12 months and rate of recurrent stroke at 24 months.

Key findings

• Both groups showed a decline in SBP, but those in the NCM plus HBPTM group had a relatively greater SBP reduction than those in the HBPTM alone group at 12 months (−15.1 mm Hg and −5.8 mm Hg, respectively).
• There was no difference in the rate of recurrent stroke between groups at 24 months (4.0% in the NCM plus HBPTM group and 4.0% in the HBPTM alone group).
• The findings support the implementation of an NCM-enhanced HBPTM program for management of hypertension in low-income Black and Hispanic stroke survivors with uncontrolled hypertension.

Sources:

Ogedegbe G, et al. (2024, June 6). JAMA. Home Blood Pressure Telemonitoring and Nurse Case Management in Black and Hispanic Patients With Stroke: A Randomized Clinical Trial. https://pubmed.ncbi.nlm.nih.gov/38842799/

Walek, S. (2024, June 6). NYU Langone Health News Hub. Adding nurse case managers to telehealth significantly lowers blood pressure in Black and Hispanic stroke survivors. [News release]. https://nyulangone.org/news/adding-nurse-case-managers-telehealth-significantly-lowers-blood-pressure-black-hispanic-stroke-survivors