Two out of every three adults in the U.S. have higher than recommended blood pressure, according to the Centers for Disease Control and Prevention (CDC). Of the 150 million affected people, half have hypertension and the other half have prehypertension, which is defined as blood pressure numbers higher than ideal but not in the high blood pressure range. We have written about a multitude of wearable and proximity devices that read and monitor blood pressure via a variety of biosensors. Recent articles include Omron’s HeartGuide smartwatch and Aktila‘s continuous optical blood pressure monitoring.

While developments in personal hypertension tracking are important, biosensing devices don’t treat the condition beyond keeping patients informed of their numbers. The American Heart Association published a study in the July 2018 issue of Circulation that showed that behavioral e-counseling can significantly lower blood pressure and cardiovascular disease (CVD) risk among patients with hypertension. The AHA trial was a year-long double-blind, randomized control test with 264 hypertensive patients. Half of the participants – the control group – were assigned to receive self-care education via the test platform. The test group received behavioral e-counseling following a standardized protocol. The content for the test and control groups included information on exercise, diet, medication adherence, and smoking cessation. The test subjects’ blood pressure was measured at the beginning of the study, after four months, and after 12 months. Both groups showed improvements during the study, but the e-counseling group had significantly greater improvement in pulse pressure and systolic blood pressure than the control group. Males in the e-counseling group also had more improvement in diastolic blood pressure than the control group, but females showed no change in diastolic blood pressure in either group.

The AHA study showed that behavioral e-counseling resulted in long-term therapeutic benefit for reducing hypertension and cardiovascular risk. The positive outcomes with the e-counseling group support the further clinical study of best-evidence protocol e-counseling. The test groups in the AHA study had blood pressure measurement in a clinical setting with automated equipment to remove any chance of clinician bias or variation. One of the goals of the study was to assess the effectiveness of counseling via computer, saving travel time and expense, but for test purposes, the patients still had to travel to a clinical setting for the BP readings. If e-counseling for hypertension proves effective in future studies, the need to travel for measurements would be reduced or eliminated, which opens the internet-connected world to the benefits of e-counseling for hypertension when used with personal wearable biosensors.