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<p>Increased variability in systolic blood pressure, expressed as the coefficient of variation (BPCoV), is associated with poor cardiovascular outcomes. Variability could be due to episodic non-adherence to medical recommendations in some patients. Reports of targeted attempts to mitigate such variation are lacking. A behavioral intervention targeted at patients with initially high BPCoV may decrease variability. In this single-site,&#xa0;single arm prospective proof-of-concept trial, an electronic health record review identified patients with excessive variability (BPCov&gt;10%). Enrolled patients received a blood pressure monitor and a remotely delivered behavioral intervention for 3 months. The primary outcome was mean blood pressure variability before versus after the intervention. Of 551 initially screened patients, 107 (19.4%) met the BPCoV criteria, and 25 consented (6 females and 19 males, mean age 64.24 years). Average BPCoV for the 6 months pre-enrollment was 12.96 (<i>SD</i>=2.11) compared to 7.02 (<i>SD</i>=3.54) during intervention (<i>p</i>&lt;0.001). Other variability metrics also improved. Sensitivity analyses (different timeframes, using measurements obtained in the clinic vs. home monitor) all showed significant improvement. This proof-of-concept trial suggests that patients with high systolic blood pressure variability can successfully engage in a remotely delivered behavioral intervention, and that such an intervention can reduce such variability. </p><p><b>Trial Registration:</b> NCT05814562, ClinicalTrials.gov.</p>

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Reducing blood pressure variability–results from a single-arm proof of concept prospective trial

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2025年8月12日

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  • Eyal Shemesh,
  • Deborah Reynolds,
  • Jasleen Sidhu,
  • Sarah Duncan-Park,
  • Rebecca A. Tejiram,
  • Beth A. Davison,
  • Koji Takagi,
  • Chris Edwards,
  • David Rubinstein,
  • Rachel A. Annunziato,
  • Gad Cotter

摘要

Increased variability in systolic blood pressure, expressed as the coefficient of variation (BPCoV), is associated with poor cardiovascular outcomes. Variability could be due to episodic non-adherence to medical recommendations in some patients. Reports of targeted attempts to mitigate such variation are lacking. A behavioral intervention targeted at patients with initially high BPCoV may decrease variability. In this single-site, single arm prospective proof-of-concept trial, an electronic health record review identified patients with excessive variability (BPCov>10%). Enrolled patients received a blood pressure monitor and a remotely delivered behavioral intervention for 3 months. The primary outcome was mean blood pressure variability before versus after the intervention. Of 551 initially screened patients, 107 (19.4%) met the BPCoV criteria, and 25 consented (6 females and 19 males, mean age 64.24 years). Average BPCoV for the 6 months pre-enrollment was 12.96 (SD=2.11) compared to 7.02 (SD=3.54) during intervention (p<0.001). Other variability metrics also improved. Sensitivity analyses (different timeframes, using measurements obtained in the clinic vs. home monitor) all showed significant improvement. This proof-of-concept trial suggests that patients with high systolic blood pressure variability can successfully engage in a remotely delivered behavioral intervention, and that such an intervention can reduce such variability.

Trial Registration: NCT05814562, ClinicalTrials.gov.