215: Management of hypertension by telemedicine: feasibility study and results on 100 patients

IntroductionAccording to the results of the national Health and study conducted in 2006-07, the prevalence of hypertension among 18 to 74 years old population is estimated at 31%. Among them, 20% are not treated. Among the ones who are treated, 49% are not controlled.ObjectivesThe goal of this observational study is to assess the feasibility to follow up blood pressure by telemedicine for 100 hypertensive patients to know the blood pressure profile and to adapt the treatment in real time to improve control. This work won the award “1 Mission 1 million”.Protocol of the studyThe follow up by telemedicine of the blood pressure figures is done by self measurement with 6 daily measures for not controlled hypertensive patients. The follow up is organized in 3 phases: inclusion, observation, treatment. Blood pressure is measured by oscillometry, result are transmitted directly and available for consultation on a secure web site.Patient profileMean age is 68 years old, 44 men and 56 women, 19% are not treated. 18% are treated for atrial fibrillation. Blood pressure at inclusion is 175/92.Observational Phase2 groups: 19 patients with a normal blood pressure (135/75), 81 patients not controlled (163/86) who continue the follow up by telemedicine during the treatment phase.Treatment PhaseThe adaptation of the treatment is achieved within 11 days with an average of 178/93 at inclusion, 163/86 during the observational phase and 144/78 after the last therapeutic adaptation. The decrease in blood pressure between the 2 phases is 19 mm HG for the systolic blood pressure and 8 mm for the diastolic one. It is obtained by adding another drug (47%) or changing the therapeutic class (22%) with an increase in dosage. 46% reach the objectives (