The Health and Economic Impact of Expanding Home Blood Pressure Monitoring

• Published in: American journal of preventive medicine 2023-11, Vol.65 (5), p.775-782
• Main Authors: Li, Yan, Zhang, Donglan, Li, Weixin, Chen, Zhuo, Thapa, Janani, Mu, Lan, Zhu, Haidong, Dong, Yanbin, Li, Lihua, Pagán, José A.
• Format: Article
• Language: English
• Subjects: Adult; Blood Pressure; Blood Pressure Monitoring, Ambulatory; Ethnicity; Female; Humans; Hypertension - diagnosis; Male; Minority Groups; Myocardial Infarction - diagnosis; Stroke - diagnosis; Stroke - prevention & control
• ISSN: 0749-3797; 1873-2607; 1873-2607
• DOI: 10.1016/j.amepre.2023.05.010

Home blood pressure monitoring is more convenient and effective than clinic-based monitoring in diagnosing and managing hypertension. Despite its effectiveness, there is limited evidence of the economic impact of home blood pressure monitoring. This study aims to fill this research gap by assessing the health and economic impact of adopting home blood pressure monitoring among adults with hypertension in the U.S. A previously developed microsimulation model of cardiovascular disease was used to estimate the long-term impact of adopting home blood pressure monitoring versus usual care on myocardial infarction, stroke, and healthcare costs. Data from the 2019 Behavioral Risk Factor Surveillance System and the published literature were used to estimate model parameters. The averted cases of myocardial infarction and stroke and healthcare cost savings were estimated among the U.S. adult population with hypertension and in subpopulations defined by sex, race, ethnicity, and rural/urban area. The simulation analyses were conducted between February and August 2022. Compared with usual care, adopting home blood pressure monitoring was estimated to reduce myocardial infarction cases by 4.9% and stroke cases by 3.8% as well as saving an average of $7,794 in healthcare costs per person over 20 years. Non-Hispanic Blacks, women, and rural residents had more averted cardiovascular events and greater cost savings related to adopting home blood pressure monitoring compared with non-Hispanic Whites, men, and urban residents. Home blood pressure monitoring could substantially reduce the burden of cardiovascular disease and save healthcare costs in the long term, and the benefits could be more pronounced in racial and ethnic minority groups and those living in rural areas. These findings have important implications in expanding home blood pressure monitoring for improving population health and reducing health disparities.