cardiovascularКардиоваскулярная терапия и профилактикаCardiovascular Therapy and Prevention1728-88002619-0125«SILICEA-POLIGRAF» LLC10.15829/1728-8800-2022-3212cardiovascular-3212Research ArticleАРТЕРИАЛЬНАЯ ГИПЕРТОНИЯARTERIAL HYPERTENSIONПерспективы разработки и внедрения дистанционного контроля уровня артериального давления пациентов, находящихся на диспансерном наблюденииProspects for developing and implementing remote blood pressure monitoring in patients under dispensary follow-uphttps://orcid.org/0000-0002-4453-8430ДрапкинаО. М.DrapkinaO. M.

Доктор медицинских наук, директор, член-корреспондент РАН

Москва

Moscow

drapkina@bk.ruhttps://orcid.org/0000-0003-0306-6139КорсунскийД. В.KorsunskyD. V.

Заведующий отделением реанимации и интенсивной терапии

Москва

Moscow

kors.dimitry@gmail.comhttps://orcid.org/0000-0002-2959-3781КомковД. С.KomkovD. S.

Врач-кардиолог

Надым, ЯМАО

Nadym, YaMAO

curans@ya.ruhttps://orcid.org/0000-0003-2458-3629КалининаА. М.KalininaA. M.

Доктор медицинских наук, профессор, руководитель отдела первичной профилактики хронических неинфекционных заболеваний в системе здравоохранения

Москва

Moscow

AKalinina@gnicpm.ruФГБУ «Национальный медицинский исследовательский центр терапии и профилактической медицины» Минздрава РоссииNational Medical Research Center for Therapy and Preventive MedicineГБУЗ Ямало-Ненецкого автономного округа «Надымская центральная районная больница»Nadym Central District Hospital20220103202221332123212Copyright © Драпкина О.М., Корсунский Д.В., Комков Д.С., Калинина А.М., 20222022Драпкина О.М., Корсунский Д.В., Комков Д.С., Калинина А.М.Drapkina O.M., Korsunsky D.V., Komkov D.S., Kalinina A.M.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://cardiovascular.elpub.ru/jour/article/view/3212

В последнее время использование телемедицинских технологий (ТМТ) в  сфере здравоохранения приобретает большое значение. ТМТ являются одним из способов повышения доступности медицинской помощи, в т.ч. у пациентов с повышенным уровнем артериального давления (АД). Офисное измерение АД и метод суточного мониторирования АД недостаточно точны при изучении естественных или индуцированных изменений АД в течение длительных сроков. Для подбора антигипертензивных препаратов и диагностики артериальной гипертонии (АГ) у пациентов с эмоционально-лабильным типом личности, а также при дифференциальной диагностике нормотензии, пограничной АГ на первое место выходит самоконтроль АД. Использование самоконтроля АД в качестве диагностики, подбора терапии, оценки приверженности и эффективности лечения АГ более эффективно с дистанционным, так называемым телеметрическим, контролем за уровнем АД в динамике. В статье представлены данные о мировом опыте эффективного применения динамического дистанционного мониторинга АД с использованием ТМТ.

 

Recently, the use of telemedicine technologies (TMT) in the healthcare has gained great importance. TMT is one of the ways to increase the healthcare availability, including in patients with high blood pressure (BP). Office BP measurement and 24-hour BP monitoring are not accurate enough to study natural or induced BP changes over long periods of time. For the selection of antihypertensive drugs and the diagnosis of hypertension (HTN) in patients with an emotionally unstable personality type, as well as in the differential diagnosis of normotension, preHTN, BP selfmonitoring comes first. The use of BP self-monitoring for the diagnosis, selection of therapy, assessment of adherence and effectiveness of treatment of HTN is more effective with remote, socalled telemetric, dynamic BP monitoring. The article presents world experience in the effective use of dynamic remote BP monitoring using TMT.

 

артериальная гипертониясамоконтроль артериального давлениядистанционный мониторингтелемедицинателемедицинское наблюдениеhypertensionblood pressure self-monitoringremote monitoringtelemedicinetelemedicine follow-upReferencesБуравков С. В., Григорьев А.И. Основы телемедицины. Москва: Слово, 2001. с. 109. ISBN: 5-900228-23-1.Buravkov SV. Grigoriev AI. Fundamentals of telemedicine. Moscow: Slovo, 2001. p. 109. (In Russ.) ISBN: 5-900228-23-1.Higgins JP. Smartphone Applications for Patients’ Health and Fitness. Am J Med. 2016;129(1):11-9. doi:10.1016/j.amjmed.2015.05.038.Higgins JP. Smartphone Applications for Patients’ Health and Fitness. Am J Med. 2016;129(1):11-9. doi:10.1016/j.amjmed.2015.05.038.World Health Organization. mHealth: Use of appropriate digital technologies for public health. Switzerland. 2018. https://apps.who.int/gb/ebwha/pdf_files/WHA71/A71_20-en.pdf?ua=1. (15.01.2022).World Health Organization. mHealth: Use of appropriate digital technologies for public health. Switzerland. 2018. https://apps.who.int/gb/ebwha/pdf_files/WHA71/A71_20-en.pdf?ua=1. (15.01.2022).Cowie MR, Bax J, Bruining N, et al. e-Health: a position statement of the European Society of Cardiology. Eur Heart J. 2016;37(1):63-6. doi:10.1093/eurheartj/ehv416.Cowie MR, Bax J, Bruining N, et al. e-Health: a position statement of the European Society of Cardiology. Eur Heart J. 2016;37(1):63-6. doi:10.1093/eurheartj/ehv416.Никитин П. В., Мурадянц А. А., Шостак Н. А. Мобильное здравоохранение: возможности, проблемы, перспективы. Клиницист. 2015;9(4):13-21. doi:10.17650/1818-8338-2015-9-4-13-21.Nikitin PV, Muradyants AA, Shostak NA, et al. Mobile healthcare services: possibilities, problems, prospects. The Clinician. 2015;9(4):13-21. (In Russ.) doi:10.17650/1818-8338-2015-9-4-13-21.Williams B, Mancia G, Spiering W, et al. 2018 ESC/ESH Guidelines for the management of arterial hypertension [published correction appears in Eur Heart J. 2019;40(5):475]. Eur Heart J. 2018;39(33):3021-104. doi:10.1093/eurheartj/ehy339.Williams B, Mancia G, Spiering W, et al. 2018 ESC/ESH Guidelines for the management of arterial hypertension [published correction appears in Eur Heart J. 2019;40(5):475]. Eur Heart J. 2018;39(33):3021-104. doi:10.1093/eurheartj/ehy339.Кобалава Ж. Д., Конради А. О., Недогода С. В. и др. Артериальная гипертензия у взрослых. Клинические рекомендации 2020. Российский кардиологический журнал. 2020;25(3):3786. doi:10.15829/1560-4071-2020-3-3786.Kobalava ZD, Konradi AO, Nedogoda SV, et al. Arterial hypertension in adults. Clinical guidelines 2020. Russian Journal of Cardiology. 2020;25(3):3786. (In Russ.) doi:10.15829/1560-4071-2020-3-3786.Bell K, Doust J, McGeechan K, et al. The potential for overdiagnosis and underdiagnosis because of blood pressure variability: a comparison of the 2017 ACC/AHA, 2018 ESC/ESH and 2019 NICE hypertension guidelines. J Hypertens. 2021;39(2):236-42. doi:10.1097/HJH.0000000000002614.Bell K, Doust J, McGeechan K, et al. The potential for overdiagnosis and underdiagnosis because of blood pressure variability: a comparison of the 2017 ACC/AHA, 2018 ESC/ESH and 2019 NICE hypertension guidelines. J Hypertens. 2021;39(2):236-42. doi:10.1097/HJH.0000000000002614.Townsend RR. Out-of-Office Blood Pressure Monitoring: A Comparison of Ambulatory Blood Pressure Monitoring and Home (Self) Monitoring Of Blood Pressure. Hypertension. 2020;76(6):1667-73. doi:10.1161/HYPERTENSIONAHA.120.14650.Townsend RR. Out-of-Office Blood Pressure Monitoring: A Comparison of Ambulatory Blood Pressure Monitoring and Home (Self) Monitoring Of Blood Pressure. Hypertension. 2020;76(6):1667-73. doi:10.1161/HYPERTENSIONAHA.120.14650.Gkaliagkousi E, Protogerou AD, Argyris AA, et al. Contribution of single office aortic systolic blood pressure measurements to the detection of masked hypertension: data from two separate cohorts. Hypertens Res. 2021;44(2):215-24. doi:10.1038/s41440-020-00550-9.Gkaliagkousi E, Protogerou AD, Argyris AA, et al. Contribution of single office aortic systolic blood pressure measurements to the detection of masked hypertension: data from two separate cohorts. Hypertens Res. 2021;44(2):215-24. doi:10.1038/s41440-020-00550-9.Taharboucht S, Chibane A. White-coat hypertension and arterial stiffness. Arch Cardiovasc Dis Suppl. 2022;14.1:94-5. doi:10.1016/j.acvdsp.2021.09.207.Taharboucht S, Chibane A. White-coat hypertension and arterial stiffness. Arch Cardiovasc Dis Suppl. 2022;14.1:94-5. doi:10.1016/j.acvdsp.2021.09.207.Tomitani N, Hoshide S, Kario K. Accurate nighttime blood pressure monitoring with less sleep disturbance. Hypertens Res. 2021;44(12):1671-3. doi:10.1038/s41440-021-00745-8.Tomitani N, Hoshide S, Kario K. Accurate nighttime blood pressure monitoring with less sleep disturbance. Hypertens Res. 2021;44(12):1671-3. doi:10.1038/s41440-021-00745-8.Григорьев А. И., Орлов О.И., Логинов В.А. и др. Клиническая телемедицина. Москва: Слово, 2001. с. 112-5. ISBN: 5-900228-04-5.Grigoriev AI, Orlov OI, Loginov VA, et al. Clinical telemedicine. Moscow: Slovo, 2001. pp. 112-5. (In Russ.) ISBN: 5-900228-04-5.Guirguis-Blake JM, Evans CV, Webber EM, et al. Screening for Hypertension in Adults: Updated Evidence Report and Systematic Review for the US Preventive Services Task Force. JAMA. 2021;325(16):1657-69. doi:10.1001/jama.2020.21669.Guirguis-Blake JM, Evans CV, Webber EM, et al. Screening for Hypertension in Adults: Updated Evidence Report and Systematic Review for the US Preventive Services Task Force. JAMA. 2021;325(16):1657-69. doi:10.1001/jama.2020.21669.Sanidas E, Grassos C, Papadopoulos DP, et al. Labile hypertension: a new disease or a variability phenomenon? J Hum Hypertens. 2019;33(6):436-43. doi:10.1038/s41371-018-0157-8.Sanidas E, Grassos C, Papadopoulos DP, et al. Labile hypertension: a new disease or a variability phenomenon? J Hum Hypertens. 2019;33(6):436-43. doi:10.1038/s41371-018-0157-8.Горбунов В.М. Значение самостоятельного измерения артериального давления больными с артериальной гипертензией. Кардиология. 2002;42(1):58-66.Gorbunov VM. The Value of Blood Pressure Self-Measurement by Patients with Hypertension. Kardiologiia. 2002:42(1):58-66. (In Russ.)Kario K, Shimbo D, Tomitani N, et al. The first study comparing a wearable watch-type blood pressure monitor with a conventional ambulatory blood pressure monitor on in-office and out-of-office settings. J Clin Hypertens (Greenwich). 2020;22(2):135-41. doi:10.1111/jch.13799.Kario K, Shimbo D, Tomitani N, et al. The first study comparing a wearable watch-type blood pressure monitor with a conventional ambulatory blood pressure monitor on in-office and out-of-office settings. J Clin Hypertens (Greenwich). 2020;22(2):135-41. doi:10.1111/jch.13799.Beyhaghi H, Viera AJ. Comparative Cost-Effectiveness of Clinic, Home, or Ambulatory Blood Pressure Measurement for Hypertension Diagnosis in US Adults. Hypertension. 2019;73(1):121-31. doi:10.1161/HYPERTENSIONAHA.118.11715.Beyhaghi H, Viera AJ. Comparative Cost-Effectiveness of Clinic, Home, or Ambulatory Blood Pressure Measurement for Hypertension Diagnosis in US Adults. Hypertension. 2019;73(1):121-31. doi:10.1161/HYPERTENSIONAHA.118.11715.Kario K, Kanegae H, Tomitani N, et al. Nighttime Blood Pressure Measured by Home Blood Pressure Monitoring as an Independent Predictor of Cardiovascular Events in General Practice. Hypertension. 2019;73(6):1240-8. doi:10.1161/HYPERTENSIONAHA.118.12740.Kario K, Kanegae H, Tomitani N, et al. Nighttime Blood Pressure Measured by Home Blood Pressure Monitoring as an Independent Predictor of Cardiovascular Events in General Practice. Hypertension. 2019;73(6):1240-8. doi:10.1161/HYPERTENSIONAHA.118.12740.Margolis KL, Asche SE, Dehmer SP, et al. Long-term Outcomes of the Effects of Home Blood Pressure Telemonitoring and Pharmacist Management on Blood Pressure Among Adults With Uncontrolled Hypertension: Follow-up of a Cluster Randomized Clinical Trial. JAMA Netw Open. 2018;1(5):e181617. doi:10.1001/jamanetworkopen.2018.1617.Margolis KL, Asche SE, Dehmer SP, et al. Long-term Outcomes of the Effects of Home Blood Pressure Telemonitoring and Pharmacist Management on Blood Pressure Among Adults With Uncontrolled Hypertension: Follow-up of a Cluster Randomized Clinical Trial. JAMA Netw Open. 2018;1(5):e181617. doi:10.1001/jamanetworkopen.2018.1617.Sheppard JP, Tucker KL, Davison WJ, et al. Self-monitoring of Blood Pressure in Patients With Hypertension-Related Multimorbidity: Systematic Review and Individual Patient Data Metaanalysis. Am J Hypertens. 2020;33(3):243-51. doi:10.1093/ajh/hpz182.Sheppard JP, Tucker KL, Davison WJ, et al. Self-monitoring of Blood Pressure in Patients With Hypertension-Related Multimorbidity: Systematic Review and Individual Patient Data Metaanalysis. Am J Hypertens. 2020;33(3):243-51. doi:10.1093/ajh/hpz182.Tucker KL, Sheppard JP, Stevens R, et al. Self-monitoring of blood pressure in hypertension: A systematic review and individual patient data meta-analysis. PLoS Med. 2017;14(9):e1002389. doi:10.1371/journal.pmed.1002389.Tucker KL, Sheppard JP, Stevens R, et al. Self-monitoring of blood pressure in hypertension: A systematic review and individual patient data meta-analysis. PLoS Med. 2017;14(9):e1002389. doi:10.1371/journal.pmed.1002389.Bryant KB, Sheppard JP, Ruiz-Negrón N, et al. Impact of SelfMonitoring of Blood Pressure on Processes of Hypertension Care and Long-Term Blood Pressure Control. J Am Heart Assoc. 2020;9(15):e016174. doi:10.1161/JAHA.120.016174.Bryant KB, Sheppard JP, Ruiz-Negrón N, et al. Impact of SelfMonitoring of Blood Pressure on Processes of Hypertension Care and Long-Term Blood Pressure Control. J Am Heart Assoc. 2020;9(15):e016174. doi:10.1161/JAHA.120.016174.Marco-Moreno I, Martínez-Ibañez P, Avelino-Hidalgo E, et al. Primary care doctors’ views on self-monitoring of blood pressure and self-titration among patients with uncontrolled hypertension in Spain. The ADAMPA trial focus group study. BJGP Open. 2020;4(4):bjgpopen20X101062. doi:10.3399/bjgpopen20X101062.Marco-Moreno I, Martínez-Ibañez P, Avelino-Hidalgo E, et al. Primary care doctors’ views on self-monitoring of blood pressure and self-titration among patients with uncontrolled hypertension in Spain. The ADAMPA trial focus group study. BJGP Open. 2020;4(4):bjgpopen20X101062. doi:10.3399/bjgpopen20X101062.Parati G, Dolan E, McManus RJ, Omboni S. Home blood pressure telemonitoring in the 21st century. J Clin Hypertens (Greenwich). 2018;20(7):1128-32. doi:10.1111/jch.13305.Parati G, Dolan E, McManus RJ, Omboni S. Home blood pressure telemonitoring in the 21st century. J Clin Hypertens (Greenwich). 2018;20(7):1128-32. doi:10.1111/jch.13305.Sharma K, Desai HD. Role of Self-Measured Home Blood Pressure Monitoring (HBPM) and Effectiveness of Telemedicine During the Era of COVID-19 Pandemic. SN Compr Clin Med. 2021;1-3. doi:10.1007/s42399-021-00852-0.Sharma K, Desai HD. Role of Self-Measured Home Blood Pressure Monitoring (HBPM) and Effectiveness of Telemedicine During the Era of COVID-19 Pandemic. SN Compr Clin Med. 2021;1-3. doi:10.1007/s42399-021-00852-0.Antony I, Asmar R, Carette B, et al. The REVEIL study: feasibility study of blood pressure self-monitoring. Preliminary results and patient opinions. Arch Mal Coeur Vaiss. 2001;94(8):897-900.Antony I, Asmar R, Carette B, et al. The REVEIL study: feasibility study of blood pressure self-monitoring. Preliminary results and patient opinions. Arch Mal Coeur Vaiss. 2001;94(8):897-900.Bard DM, Joseph JI, van Helmond N. Cuff-Less Methods for Blood Pressure Telemonitoring. Front Cardiovasc Med. 2019;6:40. doi:10.3389/fcvm.2019.00040.Bard DM, Joseph JI, van Helmond N. Cuff-Less Methods for Blood Pressure Telemonitoring. Front Cardiovasc Med. 2019;6:40. doi:10.3389/fcvm.2019.00040.Рогоза А. Н., Ощепкова Е.В., Цагареишвили Е.В. и др. Современные неинвазивные методы измерения артериального давления для диагностики артериальной гипертонии и оценки эффективности антигипертензивной терапии. Москва: Медика, 2007. с. 38. ISBN: 978-5-98495-010-7.Rogoza AN, Oschepkova EV, Tsagareishvili EV, et al. Modern non-invasive methods of blood pressure measurement for the diagnosis of arterial hypertension and evaluation of the effectiveness of antihypertensive therapy. Moscow: Medika, 2007. p. 38. (In Russ.) ISBN: 978-5-98495-010-7.Комков Д.С., Горячкин Е. А., Корсунский Д. В. и др. Клиническая эффективность различных моделей телемедицинских технологий у больных с артериальной гипертензией. Профилактическая медицина. 2020;23(4):27-35. doi:10.17116/profmed20202304127.Komkov DS, Goryachkin EA, Korsunskiy DV, et al. Clinical effectiveness of various models of telemedicine technologies in patients with arterial hypertension. The Russian Journal of Preventive Medicine. 2020;23(4):27-35. (In Russ.). doi:10.17116/profmed20202304127.McManus RJ, Mant J, Franssen M, et al. Efficacy of selfmonitored blood pressure, with or without telemonitoring, for titration of antihypertensive medication (TASMINH4): an unmasked randomised controlled trial. Lancet. 2018;391(10124):949-59. doi:10.1016/S0140-6736(18)30309-X.McManus RJ, Mant J, Franssen M, et al. Efficacy of selfmonitored blood pressure, with or without telemonitoring, for titration of antihypertensive medication (TASMINH4): an unmasked randomised controlled trial. Lancet. 2018;391(10124):949-59. doi:10.1016/S0140-6736(18)30309-X.Varma N, Cygankiewicz I, Turakhia M, et al. 2021 ISHNE/HRS/EHRA/APHRS collaborative statement on mHealth in Arrhythmia Management: Digital Medical Tools for Heart Rhythm Professionals: From the International Society for Holter and Noninvasive Electrocardiology/Heart Rhythm Society/European Heart Rhythm Association/Asia Pacific Heart Rhythm Society. J Arrhythm. 2021;37(2):271-319. doi:10.1002/joa3.12461.Varma N, Cygankiewicz I, Turakhia M, et al. 2021 ISHNE/HRS/EHRA/APHRS collaborative statement on mHealth in Arrhythmia Management: Digital Medical Tools for Heart Rhythm Professionals: From the International Society for Holter and Noninvasive Electrocardiology/Heart Rhythm Society/European Heart Rhythm Association/Asia Pacific Heart Rhythm Society. J Arrhythm. 2021;37(2):271-319. doi:10.1002/joa3.12461.Ощепкова Е.В., Цагареишвили Е.В., Зелвеян П.А. и др. Самоконтроль артериального давления в домашних условиях — метод повышения приверженности к лечению больных артериальной гипертонией. Терапевтический архив. 2004;79(4):90-4.Oschepkova EV, Tsagareishvili EV, Zelveyan PA, et al. Self-control of arterial pressure at home as a method of improving compliance in hypertensive patients. Terapevticheskii Arkhiv. 2004;79(4):90- 4. (In Russ.)Omboni S, McManus RJ, Bosworth HB, et al. Evidence and Recommendations on the Use of Telemedicine for the Management of Arterial Hypertension: An International Expert Position Paper. Hypertension. 2020;76(5):1368-83. doi:10.1161/HYPERTENSIONAHA.120.15873.Omboni S, McManus RJ, Bosworth HB, et al. Evidence and Recommendations on the Use of Telemedicine for the Management of Arterial Hypertension: An International Expert Position Paper. Hypertension. 2020;76(5):1368-83. doi:10.1161/HYPERTENSIONAHA.120.15873.Barnett J, Harricharan M, Fletcher D, et al. myPace: an integrative health platform for supporting weight loss and maintenance behaviors. IEEE J Biomed Health Inform. 2015;19(1):109-16. doi:10.1109/JBHI.2014.2366832.Barnett J, Harricharan M, Fletcher D, et al. myPace: an integrative health platform for supporting weight loss and maintenance behaviors. IEEE J Biomed Health Inform. 2015;19(1):109-16. doi:10.1109/JBHI.2014.2366832.Toro-Ramos T, Lee DH, Kim Y, et al. Effectiveness of a Smartphone Application for the Management of Metabolic Syndrome Components Focusing on Weight Loss: A Preliminary Study. Metab Syndr Relat Disord. 2017;15(9):465-73. doi:10.1089/met.2017.0062.Toro-Ramos T, Lee DH, Kim Y, et al. Effectiveness of a Smartphone Application for the Management of Metabolic Syndrome Components Focusing on Weight Loss: A Preliminary Study. Metab Syndr Relat Disord. 2017;15(9):465-73. doi:10.1089/met.2017.0062.Patel ML, Hopkins CM, Brooks TL, et al. Comparing SelfMonitoring Strategies for Weight Loss in a Smartphone App: Randomized Controlled Trial. JMIR Mhealth Uhealth. 2019;7(2):e12209. doi:10.2196/12209.Patel ML, Hopkins CM, Brooks TL, et al. Comparing SelfMonitoring Strategies for Weight Loss in a Smartphone App: Randomized Controlled Trial. JMIR Mhealth Uhealth. 2019;7(2):e12209. doi:10.2196/12209.Whitelock V, Kersbergen I, Higgs S, et al. A smartphone based attentive eating intervention for energy intake and weight loss: results from a randomised controlled trial. BMC Public Health. 2019;19(1):611. doi:10.1186/s12889-019-6923-x.Whitelock V, Kersbergen I, Higgs S, et al. A smartphone based attentive eating intervention for energy intake and weight loss: results from a randomised controlled trial. BMC Public Health. 2019;19(1):611. doi:10.1186/s12889-019-6923-x.Bai J, Zhang Y, Dai B, et al. The design and preliminary evaluation of a home electrocardiography and blood pressure monitoring network. J Telemed Telecare. 1996;2(2):100-6. doi:10.1177/1357633X9600200206.Bai J, Zhang Y, Dai B, et al. The design and preliminary evaluation of a home electrocardiography and blood pressure monitoring network. J Telemed Telecare. 1996;2(2):100-6. doi:10.1177/1357633X9600200206.Monahan M, Jowett S, Nickless A, et al. Cost-Effectiveness of Telemonitoring and Self-Monitoring of Blood Pressure for Antihypertensive Titration in Primary Care (TASMINH4). Hyper tension. 2019;73(6):1231-39. doi:10.1161/HYPERTENSIONAHA.118.12415.Monahan M, Jowett S, Nickless A, et al. Cost-Effectiveness of Telemonitoring and Self-Monitoring of Blood Pressure for Antihypertensive Titration in Primary Care (TASMINH4). Hyper tension. 2019;73(6):1231-39. doi:10.1161/HYPERTENSIONAHA.118.12415.

The authors declare that there are no conflicts of interest present.