Targeting better hypertension control with the usage of the ESH smartphone application

Clinical Snapshot

Key Findings

• P Value: P = 0.002

• Effect Size: 28.2% absolute difference in achieving BP targets

• Primary Outcome: 78.2% in AAS group vs 50% in usual care group achieved ambulatory BP targets (<130/80 mmHg)

• Nnt Or Sensitivity: NNT = 4 (approximately 1 in every 4 patients treated with app will achieve additional BP control)

• Confidence Interval: Not reported in abstract

Clinical Application

Requires smartphone access and digital literacy. May reduce clinic visit burden while maintaining effective monitoring Relevant to Australian practice given similar hypertension prevalence and smartphone adoption. Could complement existing telehealth initiatives and reduce healthcare system burden. Compatible with RACGP guidelines emphasising patient-centred care and technology integration Hypertensive patients with uncontrolled BP despite treatment, particularly those comfortable with smartphone technology

Abstract

AIMS: Uncontrolled blood pressure is a main issue in the management of hypertensive patients, while mobile health (mHealth) offers a new perspective. This study aimed to investigate the efficacy of an mHealth app-based intervention, the European Society of Hypertension (ESH) CARE, in the management of uncontrolled hypertensive patients. METHODS AND RESULTS: This was a two-arm randomized, controlled trial conducted among 107 hypertensive patients, with uncontrolled office (≥140/90 mmHg) and 24-h ambulatory blood pressure (≥130/80 mmHg). After antihypertensive drug treatment initiation or intensification, patients were 1:1 randomized to application assisted strategy (AAS) group or usual care group, with scheduled visits at 1 and 3 months. In ASS group there was a virtual visit, while in usual care group there was an office visit. At 6 months, there was a final visit assessment with office and ambulatory blood pressure (BP) measurement. The mean age of the total population (n = 107) was 52.9 ± 9.6 years, 50.5% were women, without any significant differences in the baseline characteristics. At 6 months, 50% in the usual care group and 78.2% in the AAS group (P = 0.002) achieved both systolic and diastolic ambulatory BP targets (<130/80 mmHg). Regarding office BP, there was a reduction of 19.9 ± 9.1/12.4 ± 7.7 mmHg in the usual care group and 25.1 ± 6.4/16.3 ± 6.3 mmHg in the AAS group, while regarding ambulatory BP, there was a reduction of 6.6 ± 9.2/3.3 ± 6.2 mmHg and 10.9 ± 9.1/6.4 ± 5.5 mmHg, respectively. CONCLUSION: Follow-up of hypertensive patients with the ESH Care App is feasible and contributes to a significantly better office and out-of-office BP control after 6 months. Uncontrolled blood pressure is a main issue in the management of hypertensive patients, while mobile health (mHealth) offers a new perspective. This study aimed to compare the efficacy of an mHealth app-based—ESH Care App—intervention to usual clinical care, in the management of uncontrolled hypertensive patients. Telemonitoring with the ESH Care App is associated with: Significantly improvement in office and ambulatory blood pressure control. Significantly greater reduction in office and ambulatory BP measurements.

References

1. 1.Konstantinidis, D., Siafi, E., Iliakis, P., Mihas, C., Tatakis, F., Tsioufis, P., Kasiakogias, A., Dimitriadis, K., Protogerou, A., Kollias, A., Parati, G., & Tsioufis, K. (2026). Targeting better hypertension control with the usage of the ESH smartphone application. European Journal of Preventive Cardiology. https://doi.org/10.1093/eurjpc/zwaf240