Hypertension Management Using Telemonitoring

Patients with elevated BP, identified by the electronic medical record, will be recruited for
study enrollment. Patients will be mailed a telemonitoring kit including an electronic tablet
equipped with a wireless BP cuff that transmits measurements directly to the UMMC electronic
medical record and monitored by the UMMC Center for Telehealth. Patients will participate in
a 6 month intervention period during which they will transmit daily BP recordings with
regular contact by a Telehealth nurse coordinator who will provide education and encourage
healthy lifestyle habits. Every 2 weeks BP medications will be adjusted according to an
evidence-based treatment algorithm managed by the Center for Telehealth pharmacist using a
standardized physician-approved protocol. Data analysis will track metrics of study
enrollment, study completion, safety, therapeutic intensification, and BP change from
baseline.

Inclusion Criteria:

1. Age greater than 18 years

2. Patient of UMMC clinician approving the study

3. At least 2 clinic encounters in the past 12 months with systolic BP ≥ 140 mmHg and/or
diastolic BP ≥ 90 mmHg

Exclusion Criteria:

1. Stage 4 or 5 chronic kidney disease

2. Systolic heart failure (LVEF <50%) or major cardiovascular event (MI, stroke) within 3
months

3. Resistant hypertension (prescribed 3 or more antihypertensive medications at target
doses) or known secondary cause of hypertension

4. Pregnancy or inability/unwillingness to use birth control for women of child-bearing
potential

5. Institutionalized, dementia, limited life expectancy, uncontrolled mental illness,
substance abuse, or other conditions that would prohibit ability to perform regular
home BP monitoring