Reducing blood pressure is the key to managing the exploding chronic disease crisis in the United States
High blood pressure is a leading cause of death and disability worldwide. Over 33% of people above the age of 65 have high blood pressure. The rate of hypertension has increased by 23% in the last 13 years1 and is likely to increase by 60% till 2025.2 It is one of the leading cause of stroke and heart attack, increasing the risk by four times. In the last 13 years, the death rate due to hypertension has increased by 61%.1
It is difficult to treat as in 95% of cases there is no identifiable cause. Only 30% of people suffering from hypertension have it under control.3 Medication management is the most common form of therapy, but unfortunately, it is not entirely effective. Patients are often on more than one blood pressure medication, subjected to unwanted side effects, and have poor compliance.
It is estimated that the 2008 Per-Member-Per-Month (PMPM) cost of adults with hypertension was about $716 – almost three times the $250 PMPM of adults without hypertension3. Thus there is a great opportunity to save lives. Dr. John Sotos, a cardiologist and worldwide medical director at Intel, identified that ‘Hypertension is mobile health's biggest opportunity.'4
A study in The New England Journal of Medicine showed that reducing systolic blood pressure from the current recommendation of below 150mmHg Sys to 120mmHg lowered the risk of heart failure by 38%, risk of death by a cardiac event by 43% and the risk of death for any other reason by 27%.5
Because white coat and masked hypertension readings make diagnosis and treatment difficult, regular monitoring of blood pressure readings is needed to manage it properly. Cardiowell works by remotely monitoring and managing blood pressure and medications while empowering individuals to manage their stress and increase their wellness.
Blood Pressure Monitoring Management
Self-monitoring has been shown to reduce BP by 3.4-8.9 mmHg (Sys)6, 7 improve adherence to antihypertensive medication8, and reduce primary care consultation rates at no additional cost. 9
Research also shows that remote monitoring and management of blood pressure by pharmacists can reduce blood pressure by 10.7 mmHg (Sys).10 Other studies that add a telemonitoring component have also witnessed blood pressure drop by as much as 17 mmHg.11-13
Cardiowell’s ‘always connected’ blood pressure devices and weight scales automate data collection. Results are sent from the device over a secure cellular network making results immediately available to clinical pharmacists trained to make treatment recommendations.
Cardiowell also collects additional indicators and predictors of cardiac health such as heart rate and heart rate variability.14 Cardiowell analyses minute fluctuations between each heart beat (heart rate variability) to quantify person’s wellness and provide greater insight into cardiac health.
Heart rate variability (HRV) is considered one of the best single indicators of person’s health and an early indicator of sudden death.15 By measuring HRV over time, along with other vital signs such as blood pressure, Cardiowell helps to understand when a person is at increased risk.
Stress Management and Increased Wellness
Research suggests that stress plays a significant role in hypertension,16-22 and increases the risk of heart attacks and stroke.22-23 Many studies have shown that biofeedback based breathing exercises can reduce blood pressure by as much as 15 mmHg. 24-50 Meditation which uses breathing techniques have been shown to reduce death by cardiac events in hypertensive patients by 30%.51
Breathing and mindfulness solutions are being promoted by Blue Cross, Etna, and Kaiser because of the known benefits. The American Heart Association also recommends device-guided breathing for anyone with high blood pressure.52
Breathing at six breaths per minute has been shown to increase heart rate variability and strengthen the body’s ability to regulate blood pressure.25, 53 It works by stimulating the parasympathetic nervous system and improves synchronization of the cardiac and respiratory systems. Evidence suggests that it is also very effective in alleviating depression,54-56 a major risk factor in heart disease.
Normal respiration rate is about 12 breaths per minute (bpm), yet most people breathe at 18 bpm. Fast breathing is known to stimulate the sympathetic nervous system which over time can strain the cardiovascular system. Respiration rate, much like heart rate, is a marker for pulmonary dysfunction.
Using mindfulness principles, Cardiowell increases a person's wellness by helping them breathe slower. Over time with increased awareness and better breathing, people's wellbeing increases and their blood pressure becomes more stable.
Cardiowell combines remote monitoring and medication management with wellness and mindfulness to lower blood pressure. Cardiowell expects to help lower blood pressure from at least 140/90 mmHg to the newly recommended 120/80 mmHg. Based on research, this is projected to help reduce the rate of stroke by around 25% and heart attacks by 20%.5
The greatest predictor of a second heart attack or stroke is having uncontrolled blood pressure. Cardiowell can also be used by patient-centered homes allowing chronic disease patients and post-acute patients to be remotely cared for. Patients benefit from having to take fewer medications thus decreasing the number of side effects, while at the same time it helps payers reduce population risks and costs.
Cardiowell is available today for employers and consumers as part of a physician-led care plan to help reduce the risks associated with hypertension. Learn more at www.cardiowell.io
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