Document Detail


The use of a telematic connection for the follow-up of hypertensive patients improves the cardiovascular prognosis.
MedLine Citation:
PMID:  15942466     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Inadequate blood pressure (BP) control could be due to incorrect management of hypertensives caused by the lack of interaction between general practitioners (GP) and hypertension specialists. OBJECTIVES: To test the effectiveness on BP and total cardiovascular risk (TCVR) control of an internet-based digital network connecting specialists and GPs. METHODS: We created a network among the Hypertension Clinic, Federico II University (Naples, Italy), 23 hospital-based hypertension clinics and 60 GPs from the area (CampaniaSalute Network, CS). Randomized GPs enrolled in CS could update online records of patients (n = 1979). As a control, we included 2045 patients referred to the specialist clinics by GPs from outside the network. All patients completed a 2-year follow-up. RESULTS: CS provided a larger reduction in BP [systolic/diastolic BP (SBP/DBP): 7.3 +/- 0.4/5.4 +/- 0.3 versus 4.1 +/- 0.4/3.1 +/- 0.26 mmHg, CS versus control; P < 0.001 for both] and percentage of patients with BP < 140/90 mmHg (CS versus control: baseline, 33 versus 34%, NS; end of follow-up, 51 versus 47%, chi = 13.371; P < 0.001). A European Society of Hypertension-European Society of Cardiology (ESH/ESC) TCVR score was calculated [from 1 (average) to 5 (very high TCVR)]. The CS group showed a reduction in the mean TCVR score (CS: from 3.5 +/- 0.02 to 3.2 +/- 0, P < 0.01, ANOVA; control group: 3.5 +/- 0.03 to 3.4 +/- 0.03, NS) and, accordingly, fatal and non-fatal major cardiovascular events (MACE) were less frequent (2.9 versus 4.3%; chi = 5.047, P < 0.02). CS predicts fewer MACE in multiple binary regression analysis (beta:-7.27, P < 0.008) reducing the risk for MACE compared to control [odds ratio (OR): 0.838; 95% confidence interval (CI): 0.73-0.96]. CONCLUSION: Our results support the idea that telemedicine can achieve better control of BP and TCVR.
Authors:
Nicola De Luca; Raffaele Izzo; Guido Iaccarino; Pier Luigi Malini; Carmine Morisco; Francesco Rozza; Gianni Luigi Iovino; Maria Assunta Elena Rao; Clara Bodenizza; Francesca Lanni; Luigi Guerrera; Oreste Arcucci; Bruno Trimarco
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Journal of hypertension     Volume:  23     ISSN:  0263-6352     ISO Abbreviation:  J. Hypertens.     Publication Date:  2005 Jul 
Date Detail:
Created Date:  2005-06-08     Completed Date:  2005-11-10     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8306882     Medline TA:  J Hypertens     Country:  England    
Other Details:
Languages:  eng     Pagination:  1417-23     Citation Subset:  IM    
Affiliation:
Dipartimento di Medicina Clinica, Scienze Cardiovascolari ed Immunologiche. Università degli studi Federico II, Napoli, Italy.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Analysis of Variance
Blood Pressure Determination
Cardiovascular Diseases / diagnosis*
Chi-Square Distribution
Family Practice / statistics & numerical data
Female
Follow-Up Studies
Hospitals / statistics & numerical data
Humans
Hypertension / diagnosis*
Internet
Logistic Models
Male
Middle Aged
Odds Ratio
Prognosis
Referral and Consultation / statistics & numerical data
Risk Factors
Telemedicine*
Time Factors

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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