Page 14 - hypertension_newsletter9

REFLECTIONS
Hypertension
Hypertension Global Newsletter #9 2025

Results demonstrated that both TM and HBPM produced greater BP reductions compared to usual care. TM was associated
with a mean decrease in SBP of –3.69 mmHg (95% CI –5.82 to –1.57; P < 0.001) and DBP of –1.82 mmHg (95% CI –2.98 to
–0.67; P < 0.001). HBPM also reduced BP compared to usual care, lowering SBP by –2.73 mmHg (95% CI –5.69 to 0.22; P =
Hypertension
0.069) and DBP by –2.09 mmHg (95% CI –3.66 to –0.52; P < 0.001). The SBP reduction was statistically significant in the TM
group, but not in the HBPM group, whereas the fall in DBP was statistically significant in both groups. Postintervention values
were similarly lower with both approaches, and there was no statistically significant difference between the two approaches.

The meta-analysis found that both SBP and DBP declined more with HBPM than the usual care, the fall being statistically
significant only for DBP. Similarly, comparison of postintervention SBP and DBP showed lowering of both in the HBPM group;
however, the reduction was significant only for postintervention SBP. Regardless of the statistical significance, the authors note
that the trend shows there is some lowering of BP in the HBPM group compared to the usual care group.

Forest plot and ranking table of network meta-analysis results
for postintervention systolic (left) and diastolic (right) BP (mmHg)

BP, blood presssure; CI, confidence interval; MD, mean difference.

Clinically, these findings are very meaningful, even small
BP reductions (about 2 mmHg in SBP) are associated with CLINICAL PEARLS FROM THE FACULTY
4% lower coronary mortality, 6% lower stroke mortality,
and 3% lower all-cause mortality. Thus, both HBPM and
TM offer practical, evidence-based strategies for improving
BP control, potentially reducing CV burden. Importantly,
given the absence of a clear advantage of TM over HBPM,
implementation strategies should consider cost-effectiveness,
accessibility, and patient adherence. Future research should
prioritise head-to-head comparisons of TM and HBPM, long-
term outcomes, and economic analyses to guide clinical and
policy decisions.
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