LOWERING BLOOD PRESSURE - TREATMENT BY PHONE WORKS!
More than any other ethnic group, African-Americans are afflicted with high blood pressure - the "silent killer," as the American Heart Association calls the disease. Moreover, certain individuals have difficulty controlling their hypertension even with drugs.
Telemedicine can work, however, even when medication alone doesn't.
In a University of Illinois study published this week in the spring issue of Telemedicine Journal, researchers in the UIC College of Medicine found that a small monitoring device placed in the home, and linked by telephone to a university server, was remarkably successful in helping African-Americans bring their blood pressure under control.
The monitoring device, which has a digital display, notifies a patient when it is time to record his/her blood pressure. Once a reading is taken, the device automatically transmits the information to UIC over the patient's telephone line. At UIC, computer software scans the incoming data and immediately sounds an alarm if any of the numbers are outside normal ranges. A technician reviews the data and, if necessary, notifies an advance practice nurse, who works closely with a cardiologist. The nurse then calls the patient to determine whether any adjustment in medication is needed or whether a change in eating or exercise habits may resolve the problem. The device is used until the patient has brought his/her blood pressure under control and has demonstrated that he/she understands the multiple factors that contribute to hypertension.
"The daily feedback and the education we can provide over the telephone are of tremendous value," said UIC nurse researcher Mary Bondmass, one of the authors of the study. "If patients eat salty food one day and sees their blood pressure go up the next, they can immediately understand the relationship between the two."
The study, conducted under the direction of UIC cardiologist Boaz Avitall, included 33 African- Americans aged 37 to 65 years; 70 percent were women. Before enrolling in the study, all had taken medication for at least a year, with no improvement.
Patients significantly lowered their blood pressure readings and maintained them throughout the period of study. Systolic pressures dropped from a mean of 154 to 141, and diastolic pressures dropped from a mean of 90 to 83. A blood pressure value that is less than 140/90 is considered "under control"; less than 120/80 is optimal.
Telemedicine has been shown to be a cost-effective means of addressing hypertension. It is particularly cost-effective in the long run, Bondmass emphasized. That is, by learning to lower their blood pressure now through telemedicine, patients decrease their risk of future illnesses such as stroke, heart disease, and kidney disease, all of which can require costly medical care and reduce the quality of life.
According to the American Heart Association, hypertension affects 28 percent of non-Hispanic blacks. It is the number one preventable cause of more than 65,000 deaths each year in this population. Direct expenditures for the medical treatment of African-Americans with high blood pressure is approximately $1.25 billion annually.
The UIC College of Medicine is the nation's largest medical school. One out of six Illinois doctors is a graduate of the college, as are 70 percent of the minority physicians practicing in Chicago. The college produces more medical school faculty than all but five schools in the country.
With 25,000 students, the University of Illinois at Chicago is the largest and most diverse university in the Chicago area and one of only 88 national Research I universities. Located just west of Chicago's Loop, UIC is a vital part of the educational, technological and cultural fabric of the entire metropolitan region.
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