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Original research
Effects of self-monitoring devices on blood pressure in older adults with hypertension and diabetes: a randomised controlled trial
  1. Yeqing Gu1,
  2. Xue Bao1,
  3. Yanyan Wang1,
  4. Ge Meng1,2,
  5. Hongmei Wu1,
  6. Qing Zhang3,
  7. Li Liu3,
  8. Kun Song3,
  9. Yaogang Wang4,
  10. Kaijun Niu1,3,5,6
  1. 1 Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, China
  2. 2 Department of Toxicology and Sanitary Chemistry, School of Public Health, Tianjin Medical University, Tianjin, China
  3. 3 Health Management Centre, Tianjin Medical University General Hospital, Tianjin, China
  4. 4 School of Public Health, Tianjin Medical University, Tianjin, China
  5. 5 Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin, China
  6. 6 Center for International Collaborative Research on Environment, Nutrition and Public Health, Tianjin, China
  1. Correspondence to Dr Kaijun Niu, Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin 300070, China; nkj0809{at}gmail.com

Abstract

Background Hypertension and diabetes frequently coexist, which results in the difficulty of hypertension control in community-dwelling elderly adults who lack effective prevention and control strategies. The aim of this study is to determine whether a combined pedometer and home blood pressure monitoring (HBPM) programme could improve blood pressure (BP) among community-dwelling elderly adults with hypertension and diabetes.

Methods The trial was a 2×2 factorial randomised clinical trial that recruited 180 community-dwelling elderly people (aged ≥60) with hypertension and diabetes in Tianjin, China. Participants were randomly assigned to control, pedometer, HBPM, and pedometer+HBPM groups. Intervention period was 12 months. The coprimary outcomes of the study were systolic and diastolic BP; the secondary outcomes included the proportion of patients with controlled hypertension. BP was measured twice in the right arm using a mercurial sphygmomanometer. The mean of these two measurements was taken as the BP value.

Results At 12 months, compared with the control group, the adjusted differences in least squares mean (95% CI) in systolic and diastolic BP changes for pedometer, HBPM, and pedometer+HBPM groups were −4.2 (–8.4 to 0.1), –2.7 (–6.9 to 1.5) and −8.1 (–12.3 to –3.9) mm Hg (p<0.01); −3.2 (–5.2 to –1.1), −0.1(−2.1 to 1.9) and −3.6 (–5.6 to –1.5) mm Hg (p<0.001), respectively; the adjusted difference in percentage (95% CI) in the controlled hypertension (BP <140/90 mm Hg) for pedometer, HBPM and pedometer+HBPM groups were 7.5 (–12.2 to 27.1), 9.9 (–10.4 to 30.3) and 23.1 (5.0 to 41.1) (p=0.09).

Conclusion Combination pedometer and HBPM interventions can significantly decrease BP levels in elderly adults with hypertension and diabetes.

Trials Registration number UMIN000021613.

  • pedometer
  • home blood pressure monitoring
  • hypertension
  • older
  • Randomised controlled trial

http://dx.doi.org/10.1136/jech-2019-212531

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    Footnotes

    • Contributors KN had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis. Study concept and design: YG, XB, GM, HW, KN; Acquisition, analysis, or interpretation of data: YG, XB, YW, GM, HW, QZ, LL, KS, YW, KN; Drafting of the manuscript: YG; Critical revision of the manuscript for important intellectual content: YG, KN; Statistical analysis: YG, KN; Obtained funding: KN; Administrative, technical, or material support: QZ, LL, KS, YW, KN; Study supervision: KN.

    • Funding This study was supported by grants from the National Natural Science Foundation of China (No. 91746205), China.

    • Competing interests None declared.

    • Patient consent for publication Not required.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data availability statement Data are available upon reasonable request. For data access, researchers can contact the Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, China (E-mail address: nkj0809{at}gmail.com or niukaijun{at}tmu.edu.cn).