Effects of nurse-managed telemonitoring on blood pressure at 12-month follow-up among urban African Americans
Effects of nurse-managed telemonitoring on blood pressure at 12-month follow-up among urban African Americans
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DOI：
10.1097/01.nnr.0000289501.45284.6e
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发表时间：
2007-09-01
期刊：
影响因子：
2.5
通讯作者：
Fathy, Maryam
中科院分区：
文献类型：
--
作者：
Artinian, Nancy T.;Flack, John M.;Fathy, Maryam
背景：在美国，近三分之一的成年人患有高血压。高血压是心血管疾病的最大危险因素之一，其患病率正在上升，尤其是在非洲裔American.Objectives：为了验证以下假设：与仅接受UC治疗的个体相比，参与常规护理（UC）加血压（BP）远程监测（TM）的个体从基线到12个月随访的BP降低幅度更大。采用两组、实验性、纵向设计，抗高血压药物的使用采用区组分层随机化。患有高血压的非裔美国人是通过社区提供的免费BP筛查招募的。通过结构化访谈和简单的体格检查收集数据，采用交叉表、重复测量方差分析和独立t检验分析研究假设。结果：TM干预组收缩压下降幅度更大从基线到12个月随访，增强型UC组（7.5 mm Hg; t =-2.09，p = .04）的平均血压（13.0 mm Hg）高于增强型UC组（7.5 mm Hg; t =-2.09，p = .04）。尽管TM干预组的舒张压降低幅度更大，（6.3 mm Hg）与增强UC组相比（4.1 mm Hg），差异无统计学意义（t 1，56，p = 0.12）.讨论：在12个月期间，血压的远程监测导致收缩压在临床上和统计学上显著降低;如果维持较长时间，这种降低可以显著改善非洲裔美国人高血压患者的护理和预后。
Background: Nearly one in three adults in the United States has hypertension. Hypertension is one of the largest risk factors for cardiovascular diseases, and it is growing in prevalence, especially among African Americans.Objectives: To test the hypothesis that individuals who participate in usual care (UC) plus blood pressure (BP) telemonitoring (TM) will have a greater reduction in BP from baseline to 12-month follow-up than would individuals who receive UC only.Methods: A two-group, experimental, longitudinal design with block stratified randomization for antihypertensive medication use was used. African Americans with hypertension were recruited through free BP screenings offered in the community. Data were collected through a structured interview and brief physical exam. Cross tabs, repeated measures analysis of variance, and independent t tests were used to analyze the study's hypothesis.Results: The TM intervention group had a greater reduction in systolic BP (13.0 mm Hg) than the enhanced UC group (7.5 mm Hg; t = -2.09, p = .04) from baseline to the 12-month follow-up. Although the TM intervention group had a greater reduction in diastolic BP (6.3 mm Hg) compared with the enhanced UC group (4.1 mm Hg), the differences were not statistically significant (t 1,56, p = .12).Discussion: Telemonitoring of BP resulted in clinically and statistically significant reductions in systolic BP over a 12-month period; if maintained over a longer period of time, the reductions could improve care and outcomes significantly for African Americans with hypertension.