Evaluating the Impact and Efficacy of Wireless Blood Pressure Self-Monitoring for the Treatment of Uncontrolled Hypertension in a West Virginia Federally Qualified Health Center

Background Hypertension (HTN) is a leading cause of stroke, cardiovascular complications, and mortality worldwide, but self-measured blood pressure (SMBP) monitoring has been shown to improve blood pressure control when integrated into clinical management approaches. This project aimed to evaluate the impact and efficacy of wireless blood pressure self-monitoring in patients with uncontrolled hypertension at Cabin Creek Health Systems, a federally qualified health center located in West Virginia. This retrospective quality improvement evaluation examined the implementation of wireless SMBP from January 2020 – March 2023, assessing its impact on blood pressure control in patients with uncontrolled HTN. This evaluation focuses on 401 individuals who were enrolled with Stage 2 HTN (systolic ≥ 140 mmHg and/or diastolic ≥ 90 mmHg), or above, as these patients are at highest risk for adverse cardiovascular events. Results The percentage of patients in the controlled range (systolic < 140 mmHg and/or diastolic < 90 mmHg) increased from 0–56.1%, with an average reduction in systolic and diastolic blood pressures of 20.5 mmHg and 11.2 mmHg, respectively ( P  < .0001 for both). Furthermore, all patients achieved significant reductions in blood pressure regardless of the number of chronic conditions present at the time of enrollment. Notably, patients with ≥ 5 conditions achieved an average reduction in systolic and diastolic blood pressures of 20.5 mmHg and 11.3 mmHg, respectively. The subsequent evaluation of clinical parameters in individuals whose lipid values were abnormal at enrollment indicated significant improvements in laboratory values, in addition to improved blood pressure control, including decreased total cholesterol ( P  = .002), triglycerides ( P  = .004), low-density lipoprotein ( P  = .004), and very low-density lipoprotein ( P  = .007), and an increase in female high-density lipoprotein ( P  = .03). Conclusions Wireless SMBP monitoring was successfully implemented in rural southern West Virginia and achieved significant improvements in blood pressure and lipid control in patients with uncontrolled HTN. Further, improvements in blood pressure control were observed consistently across all demographic indices, and regardless of the number of chronic conditions present, indicate that incorporating wireless SMBP into clinical workflows and standard care procedures may be an effective method of reducing uncontrolled HTN and improving care for patients with multi-faceted health needs in resource limited settings.