Pilot shows app improves blood pressure control

Using a smartphone app, patients with diabetes and uncontrolled hypertension were able to significantly reduce their blood pressure within six weeks.

That’s the finding of a pilot study funded by vendor Livongo, the maker of the app that remotely monitors blood pressure, provides recommendations on healthy choices and connects users with a health coach.

The study’s results, which will be presented later this month at the American College of Cardiology’s Annual Scientific Session in New Orleans, show that participants’ systolic blood pressure declined by an average of 5.4 mm Hg and diastolic pressure declined by 3.5 mm Hg on average.

“We have shown in this pilot study that, in a population with both diabetes and high blood pressure, six weeks of remote blood pressure monitoring—accompanied by education about high blood pressure management and access to health coaches—can significantly improve blood pressure control,” says lead author Bimal R. Shah, MD, chief medical officer of Livongo and assistant consulting professor at Duke University School of Medicine.

“The improvement is comparable to what doctors would expect to see if a patient had started taking a low to moderate dose of a high blood pressure medication,” adds Shah.

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All of the study’s 708 participants had diabetes, and 63 percent had blood pressure higher than 130/80 mm Hg—the threshold for a diagnosis of stage 1 high blood pressure, according to the revised 2017 guideline issued by ACC and the American Heart Association. In addition, a subgroup (28.7 percent) had blood pressure higher than 140/90 mm Hg—the threshold for stage 2 high blood pressure, according to the guideline.

At six weeks, 40.8 percent of participants had blood pressure below 130/80 mm Hg, while 23.6 percent still had blood pressure higher than 140/90 mm Hg.

“This was a short study to demonstrate the proof of concept,” concludes Shah. "With longer follow-up and further coaching, we expect that more participants will see durable blood pressure reductions.”

At the same time, he acknowledged the study’s limitation was that it did not include a control group that received traditional care for hypertension. As a follow up, Shah and his colleagues are planning to conduct a randomized trial to validate their findings.