Evaluation of the antihypertensive therapy efficacy with remote blood pressure monitoring using the example of a fixed combination of azilsartan and chlortalidone

Aim: to evaluate the efficacy of antihypertensive therapy (AHT) using remote blood pressure (BP) and heart rate (HR) monitoring at home. Materials and Methods: the study included 30 adult patients (≥18 years) with uncontrolled essential hypertension despite receiving 1–3 antihypertensive medications. The cohort comprised 11 males and 19 females, with a mean age of 58.65±11.03 years. All participants underwent a comprehensive physical examination and medical history assessment to determine cardiovascular risk. Office blood pressure measurements were obtained, and patients completed a quality of life questionnaire using a visual analog scale (VAS) and an adherence assessment using the Morisky-Green scale. Psychological status was evaluated with the Hospital Anxiety and Depression Scale (HADS). At baseline (visit 0), patients were screened and provided with automated BP monitors equipped with GSM modules for remote BP and HR monitoring. At visit 1, all patients were initiated on a fixed-dose combination therapy of azilsartan medoxomil/chlortalidone (Az+CLT) 40 mg/12.5 mg. Visit 2 was conducted either in person or remotely four weeks following initiation of Az+CLT, at which point therapy was adjusted if necessary. Visit 3 was performed eight weeks after therapy initiation. Results: at visit 2, two patients required therapeutic adjustments – increasing the dose to a maximum of 40+25 mg (Edarbi® Clo) according to the instructions. By visit 3, there was a statistically significant reduction in office systolic BP (SBP), diastolic BP (DBP), and HR compared to baseline. Notably, during Az+CLT administration and normalization of BP, reductions in anxiety and depression scores (HADS) and improvements in quality of life were observed. Remote monitoring data confirmed a decrease in the mean weekly SBP and DBP at both four and eight weeks. HR did not change significantly from baseline during therapy. Based on office measurements, target BP (<130/80 mmHg) was achieved in all patients. When assessed by remote monitoring, 81.8% of patients achieved a mean weekly BP of <135/85 mmHg, while 63.6% reached <130/80 mmHg. The proportion of patients maintaining the BP target (<135/85 mmHg) at two months was 43.3% (n=13). Conclusion: remote BP and HR monitoring is a reliable and effective tool for therapy management. The fixed-dose combination of Az+CLT demonstrates efficacy both in office-based BP measurements and in long-term ambulatory BP monitoring employing remote technologies. Keywords: remote blood pressure and heart rate monitoring at home, azilsartan medoxomil/chlortalidone, hypertension, blood pressure monitoring, office blood pressure. For citation: Ageev F.T., Smirnova M.D., Fofanova T.V. Evaluation of the antihypertensive therapy efficacy with remote blood pressure monitoring using the example of a fixed combination of azilsartan and chlortalidone. RMJ. 2025;6:10–16. DOI: 10.32364/2225-2282-2025-6-3