Effect of telemonitoring and home blood pressure monitoring on blood pressure reduction in hypertensive adults: a network meta-analysis

Introduction: Telemonitoring and home blood pressure monitoring (HBPM) are becoming popular approaches for managing hypertension. They are believed to improve patient compliance as compared to the usual care monitoring. This network meta-analysis was undertaken to compare blood pressure (BP) reduction following telemonitoring, HBPM and usual care BP monitoring approaches. Methods: PubMed and clinicaltrial.gov were searched till 15 May 2024 for randomized controlled trials (RCTs) comparing telemonitoring, HBPM and usual care monitoring for reduction in BP and the postintervention BP in hypertensive adults. Results: A network meta-analysis with 24 RCTs was performed using MetaInsight. Telemonitoring produced a significantly greater reduction in the systolic blood pressure (SBP) (–3.69 mmHg [95% CI –5.82; –1.57, P < 0.001]) and the diastolic blood pressure (DBP) (–1.82 mmHg [95% CI –2.98 to –0.67, P < 0.001]) as compared to the usual care monitoring. Home BP monitoring also produced a greater lowering of SBP (–2.73 mmHg [95% CI –5.69 to 0.22, P = 0.069]) and DBP (–2.09 mm Hg [95% CI –3.66 to –0.52, P < 0.001]) than usual care, with a significant reduction in the DBP alone. The postintervention SBP and DBP were also lower in the telemonitoring and the HBPM groups than the usual care group. However, there was no significant difference between the SBP and the DBP reductions in the telemonitoring and the HBPM groups. Conclusion: Telemonitoring and HBPM may be more useful in controlling BP as compared to usual care management alone. However, more direct studies comparing telemonitoring with HBPM are needed in the future.