Blood pressure outcomes following the telemonitoring program HartWacht for hypertension management: insights from real-world clinical practice

Abstract Background Hypertension remains one of the most important risk factors for cardiovascular disease, such as coronary heart disease and stroke. Despite the availability of effective medications and lifestyle modifications, many patients fail to achieve adequate blood pressure (BP) control. Telemonitoring provides a scalable, cost-effective solution to improve hypertension management. Evaluating its impact in real-world settings is crucial for optimizing hypertension management and healthcare delivery. Purpose This study assessed the effectiveness of the Dutch telemonitoring program HartWacht on BP outcomes in patients with hypertension. A secondary objective was to identify predictors of treatment response at 3- and 6-months follow-up. Methods A retrospective cohort study was conducted including hypertensive patients enrolled in HartWacht from August 2016 to December 2024. Patients were instructed to measure their BP twice daily for one week, followed by once-weekly readings. A structured alarm system identified home-measured BP (HMBP) elevations based on pre-defined thresholds: an orange alarm if systolic or diastolic HMBP exceeded 140 mmHg or 90 mmHg, respectively, and a red alarm if systolic or diastolic HMBP exceeded 180 mmHg or 110 mmHg, respectively. In the case of one red or two consecutive orange alarms, the eHealth team contacted the patient by phone to discuss lifestyle and therapy adherence. If necessary, a consultation with a cardiologist was arranged for protocol-based medication adjustment. BP control was defined as a monthly mean HMBP