Effectiveness of remote monitoring for patients with a high risk of cardiovascular disease: a 12-month matched cohort study in primary care

Abstract

Aims: This study aimed to evaluate the effect of remote monitoring using the Cardiovascular Risk Management (CVRM)-Box on blood pressure control, weight management, medication prescriptions, and consultation frequency in primary care patients at high risk of cardiovascular disease (CVD).

Methods and results: In this matched cohort study, patients with a > 5% 10-year CVD mortality risk in primary care (2020-2024) were compared to propensity score-matched controls over 12 months. The CVRM-Box included smartphone-connected devices (blood pressure monitor, weighing scale, activity tracker) linked to general practitioner electronic health records. Compared to controls, the intervention group showed modest reductions in office-measured systolic {-1.1 mmHg [95% confidence interval (CI), -3.7 to -1.5]; P = 0.39} and diastolic blood pressure [-0.04 mmHg (95% CI, -1.6 to 1.5); P = 0.96]. Sensitivity analyses yielded similar results. However, CVRM-Box assessments showed reductions in systolic [-5.5 mmHg (95% CI, -7.6 to -3.3); P < 0.001] and diastolic blood pressure [-3.8 mmHg (95% CI, -5.1 to -2.4); P < 0.001]. The intervention group also experienced greater reductions in weight [-0.9 kg (95% CI, -1.6 to -0.2); P = 0.01] and body mass index [-0.3 kg/m & sup2; (95% CI, -0.5 to -0.01); P = 0.007]. Additionally, antihypertensive medication use increased [0.12 (95% CI, 0.06 to 0.23); P = 0.04], while consultation frequency decreased (rate ratio 0.82; P = 0.002).

Conclusion: While office measurements showed no additional blood pressure reduction, CVRM-Box measurements demonstrated significant decreases. The intervention also improved target blood pressure achievement, promoted weight reduction, increased antihypertensive use, and reduced consultation frequency.