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Smartphone app doesn’t help control hypertension, researchers suggest

Using an app to track blood pressure medications did not lead to a significant reduction in blood pressure, research has found.

Patients who used a smartphone app to track their blood pressure medications and receive reminders to take them reported an almost identical reduction in blood pressure levels compared to those who didn’t use an app, the study reported.

The study, conducted by researchers in Massachusetts and California, assigned just over 400 patients with a blood pressure of 140mmHg or higher and taking between one and three antihypertensive medications to either download and use the Medisafe app or not.

Patients who downloaded the app could input their medications, receive reminders about when to take them, track blood pressure using a home blood pressure cuff and receive peer support.

Those who used the app began the study with a blood pressure of 151mmHg on average, which fell to 141mmHg after 12 weeks of using the app. Patients who did not use the app also experienced a reduction in blood pressure of around 10mmHg after 12 weeks, resulting in no significant difference between the two groups.

However, self-reported medication adherence was slightly increased in patients using the app.

The researchers said in the paper: ‘The MedISAFE-BP trial is, to our knowledge, the first randomised clinical trial reporting the effect of a stand-alone mHealth platform to increase medication adherence and improve blood pressure control. We found significant improvement in medication adherence, but no difference in systolic blood pressure between the intervention and control groups.’

However, a study in February found that when GPs titrated blood pressure medications based on blood pressure readings taken by patients at home, the patients had significantly lower blood pressures at 12 months than patients in the control group.

NICE announced last month its plans to consider guidance from the US which led to drastically lower blood pressures ahead of a proposed update to UK hypertension guidelines in 2019. The US guideline reduced the thresholds for stage one and two hypertension, which could lead to an extra 14% of people being diagnosed with high blood pressure. 

RCGP chair Professor Helen Stokes-Lampard raised concerns over overdiagnosis and potential patient harm, commenting: ‘One concern GPs already have is overdiagnosis – where we are giving a label to a situation thereby medicalising it, and prescribing medications when the benefits to the individual patient may be very limited.

‘This can be harmful for patients both in terms of causing unnecessary anxiety, and in terms of taking medication that they might not need.’

JAMA 2018; available online 16th April 


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