Effectiveness of telemedicine interventions on blood pressure control and self-management efficacy in hypertensive patients: a systematic review and meta-analysis

Objective: The objective of this study was to systematically evaluate the combined effect of a telemedicine intervention on systolic blood pressure (SBP), diastolic blood pressure (DBP), and self-management efficacy in adult hypertensive patients. Methods: On May 2025, a systematic literature search was conducted using the PubMed, Cochrane, Embase, and Web of Science databases. Randomized controlled trials (RCTs) were included to compare the effectiveness of the telemedicine group (the intervention group) with the usual care group (the control group) in controlling the blood pressure of adult patients with hypertension. Primary outcomes were SBP and DBP change values, and secondary outcomes included self-management, medication adherence, self-efficacy, weight, BMI, pulse pressure, total cholesterol, and low-density lipoprotein. Effect sizes were combined using a random-effects model, and heterogeneity was explored through subgroup analyses of mean age, intervention intensity, intervention duration, intervention mode, and region. Results: A total of 31 eligible articles, comprising 31 studies and 9,559 patients (4,685 in the intervention group and 4,874 in the control group), were included in the evidence synthesis analysis. The two groups had similar baseline characteristics for all outcomes. The pooled analysis revealed statistically significant changes in SBP and DBP, pulse pressure, and total cholesterol. Additionally, improvements in self-efficacy, self-management skills, and hypertension literacy were observed following the intervention. However, no significant differences were observed in medication adherence, weight, BMI and LDL. Subgroup analyses revealed that the intervention, which combined a remote monitoring device with an app, was more effective and had lower heterogeneity among individuals under 60 years of age in China and other East Asian regions. Conclusion: Telemedicine, which combines home blood pressure monitoring with remote support from healthcare providers, may become a promising strategy for managing hypertension. This approach can significantly reduce blood pressure levels and improve self-management efficacy in hypertensive patients. Systematic review registration: https://www.crd.york.ac.uk/PROSPERO/, identifier CRD420251083786.