Optimizing Precision of Hypertension Care to Maximize Blood Pressure Control: A Pilot Study Utilizing a Smartphone App to Incorporate Plasma Renin Activity Testing

Autor: Rhonda M. Cooper-DeHoff, Jessica De Leon, Steven M. Smith, Yiqing E Chen, Eileen M. Handberg, Brittney Roth, Mai Mehanna, Yan Gong, Jonathan G Harrell
Rok vydání: 2020
Předmět:
Blood pressure control
Adult
Male
030213 general clinical medicine
medicine.medical_specialty
Diastole
Blood Pressure
Pilot Projects
030226 pharmacology & pharmacy
Plasma renin activity
General Biochemistry
Genetics and Molecular Biology
Article
03 medical and health sciences
0302 clinical medicine
Interquartile range
Internal medicine
Renin
Medicine
Humans
General Pharmacology
Toxicology and Pharmaceutics
Antihypertensive Agents
Dose-Response Relationship
Drug
business.industry
lcsh:Public aspects of medicine
General Neuroscience
Research
lcsh:RM1-950
lcsh:RA1-1270
Mean age
Blood Pressure Determination
General Medicine
Articles
Middle Aged
Decision Support Systems
Clinical
Mobile Applications
Exact test
lcsh:Therapeutics. Pharmacology
Blood pressure
Treatment Outcome
Smartphone app
Hypertension
Female
business
Zdroj: Clinical and Translational Science
Clinical and Translational Science, Vol 14, Iss 2, Pp 617-624 (2021)
ISSN: 1752-8062
Popis: Only half of patients with hypertension (HTN) respond to any given antihypertensive medication. Heterogeneity in pathophysiologic pathways underlying HTN is a major contributor. Personalizing antihypertensive therapy could improve blood pressure (BP) reduction. The objective of this study was to assess the effect of pragmatic implementation of a personalized plasma renin activity (PRA)‐based smartphone app on improving BP reduction. Patients with untreated or treated but uncontrolled HTN were recruited. BP and PRA were measured at baseline with final BP measured at 6 months. Patient’s information was entered into the app and treatment recommendations were returned. Clinicians were at liberty to follow or disregard the app’s recommendations. BP levels and percent BP control among patients whose clinicians did and did not follow the app’s recommendations were compared using independent t‐test and Fisher’s exact test, respectively. Twenty‐nine European American patients were included (38% women) with mean age of 52 ± 9 years and median PRA of 1.3 ng/mL/hr (interquartile range 0.5–3.1 ng/mL/hr). Participants whose clinicians followed the app’s recommendations (n = 16, 55%) as compared with those whose clinicians did not (n = 13, 45%), had a greater reduction in 6‐month systolic BP (−15 ± 21 vs. −3 ± 21 mm Hg; adjusted‐P = 0.1) and diastolic BP (−8 ± 8 vs. −1 ± 8 mm Hg; adjusted‐P = 0.04). BP control at 6 months tended to be greater among patients whose clinicians accepted the app’s recommendations vs. those whose clinicians did not (63% vs. 23%, P = 0.06). This pilot study demonstrates that acceptance of the app’s recommendations was associated with a greater BP reduction. Future studies to confirm these pilot findings are warranted.
Databáze: OpenAIRE
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