Online Tracking Helps Lower Blood Pressure

An online tool can help people lower their blood pressure, researchers report. The program, called Heart360, is a free online tracking tool created by the American Heart Association. In the study, 298 people with high blood pressure were randomly divided into 2 groups. One group used Heart360. They uploaded data to the tool from their home blood pressure monitors. This information was sent to pharmacists, who were trained to monitor and adjust people's medicines. The second group received usual care from their doctors. They also received pamphlets on managing high blood pressure, diet and exercise. After 6 months, 54% of the Heart360 group had lowered blood pressure to their target levels. About 35% of people in the usual-care group reached their goals. The differences were even wider for people with diabetes or kidney problems. The journal Circulation: Cardiovascular Quality and Outcomes published the study March 5.

By Reena L. Pande, M.D.
Harvard Medical School

What Is the Doctor's Reaction?

High blood pressure remains a major problem in the Unites States. More than half of U.S. adults have poorly controlled blood pressure levels. Despite our best efforts, the treatment of high blood pressure still leaves a lot of room for improvement.

A new research study tells us that a web-based program can help more people get their blood pressure under control. The study included about 350 people with high blood pressure. Half of them took part in a free online blood pressure monitoring program created by the American Heart Association. The program, called Heart360, is available at www.heart360.org.

People in this group measured their blood pressure at home and uploaded their numbers to the website. They also had a chance to meet with a pharmacy specialist who reviewed their readings and helped adjust their medicines.

Overall, patients in the monitoring group did better than a group that received usual care for high blood pressure. They had better results in lowering blood pressure and were more satisfied with their care.

Why is it so important to get your blood pressure under control? Although most people don't "feel" the high blood pressure, it increases the risk of many serious conditions. These include:

• Heart disease
• Stroke
• Kidney failure
• Congestive heart failure

Why do people develop high blood pressure? Many people have no obvious cause, but several factors are known to increase risk:

• Older age
• Obesity
• Physical inactivity
• High salt intake
• Kidney failure
• Sleep apnea
• Thyroid problems
• Certain medicines (such as birth control pills, decongestants or taking too many nonsteroidal anti-inflammatory drugs like ibuprofen or naproxen)
• Drugs (cocaine and amphetamines)
• Too much alcohol intake
• Family history of high blood pressure

What Changes Can I Make Now?

First, talk to your doctor about whether you have any obvious cause of high blood pressure that can be treated.

You can do many other things to help get your blood pressure under control.

1. Change your lifestyle. You have the power to make changes to reduce many of the risk factors for high blood pressure. So the first steps are to work on your diet, eat less salt, try to maintain a healthy body weight and get active. Losing weight and exercising can each lower blood pressure as much as adding a new pill.

1. Review your medicines. As mentioned above, several medicines can increase blood pressure. Many of these are over-the-counter or herbal medicines. It's always a good idea to review all of your medicines, prescription and non-prescription, with your doctor.

1. Limit alcohol intake. If you drink alcohol, limit it to one to two drinks per day if you are a man or one drink per day if you are a woman. Too much alcohol can lead to high blood pressure.

1. Consider medicines. Your doctor can help you decide when a medicine may be necessary to lower your blood pressure. There are many good choices.

What Can I Expect Looking to the Future?

It can be hard to get a long-term (chronic) disease, such as high blood pressure, under control. This study shows, first and foremost, that tracking blood pressure matters. It also shows that having someone pay very close attention to your readings and help you adjust your medicines can have a big impact on lowering blood pressure even further.

In the current era of mobile technologies and web-based health applications, we are going to see big changes in the way the medical community helps patients get healthy. High blood pressure remains a major problem in the United States and around the world. New tools like this one may have a major impact on helping millions of adults gain control of their blood pressure.