Nurse-Coordinated Blood Pressure Telemonitoring for Urban Hypertensive Patients: A Systematic Review and Meta-Analysis

Abstract

Coronavirus disease 2019 (COVID-19) has put hypertensive patients in densely populated cities at increased risk. Nurse-coordinated home blood pressure telemonitoring (NC-HBPT) may help address this. We screened studies published in English on three databases, from their inception to 30 November 2020. The effects of NC-HBPT were compared with in-person treatment. Outcomes included changes in blood pressure (BP) following the intervention and rate of BP target achievements before and during COVID-19. Of the 1916 articles identified, 27 comparisons were included in this review. In the intervention group, reductions of 5.731 mmHg (95% confidence interval: 4.120–7.341; p < 0.001) in systolic blood pressure (SBP) and 2.342 mmHg (1.482–3.202; p < 0.001) in diastolic blood pressure (DBP) were identified. The rate of target BP achievement was significant in the intervention group (risk ratio, RR = 1.261, 1.154–1.378; p < 0.001). The effects of intervention over time showed an SBP reduction of 3.000 mmHg (−5.999–11.999) before 2000 and 8.755 mmHg (5.177–12.334) in 2020. DBP reduced by 2.000 mmHg (−2.724–6.724) before 2000 and by 3.529 mmHg (1.221–5.838) in 2020. Analysis of the target BP ratio before 2010 (RR = 1.101, 1.013–1.198) and in 2020 (RR = 1.906, 1.462–2.487) suggested improved BP control during the pandemic. NC-HBPT more significantly improves office blood pressure than UC among urban hypertensive patients.