Effectiveness of home blood pressure monitoring in low income adults living in rural Appalachia

Hypertension is the most common chronic condition in the United States. For many individuals proper control of their blood pressure (BP) through pharmacological intervention is not effective at maintaining a healthy BP. Team based patient focused care and home based BP monitoring in addition to pharmacological interventions have been shown to be an effective method for controlling BP. The objective of this study is to determine the effectiveness of the Heritage Community Clinic’s hypertension management program. Medical records of 43 individuals who took part in the hypertension management program were retrospectively reviewed and included clinical data such as BMI, age, gender, comorbidities, and BP, as well as demographic information. In addition to standard pharmacological interventions the program involved providing equipment for home blood pressure monitoring, education on behavior and lifestyle modification, and providing regular follow-up appointments. BP was recorded at intake and five follow-up appointments. Linear mixed-effects models of BP suggest that visit factor was significantly associated with BP (p<0.001). On average patents showed a 6.8 reduction in systolic BP and a 3.8 reduction in diastolic BP after controlling for demographic variables. General stress level, marital status, and depression were all significantly associated with BP (p<0.05). In addition, 67.5% of the patients that took part in this program achieved JNC8 target treatment guidelines for hypertension management. This pilot investigation revealed significant reductions in BP post intervention. With the national average for patients achieving JNC8 target hypertension management treatment guidelines being only 56.4%, further investigation of the clinic’s success is warranted.