A Meta-analysis of the Clinical Effectiveness of Telemedicine in the Management of Hypertension in Asia

Background The increasing burden of hypertension in Asia poses significant challenges to healthcare systems, necessitating innovative strategies for its effective management. Telemedicine is increasingly recognized as a practical strategy to enhance accessibility, treatment adherence, and clinical outcomes for individuals with hypertension. This review synthesizes evidence on the effectiveness of telemedicine compared with conventional face-to-face care for hypertension management among adults in Asia. Methods A systematic review and meta-analysis were conducted in accordance with PRISMA-P and Cochrane methodological standards and were prospectively registered in PROSPERO. Eligible studies were randomized controlled trials involving Asian adults with hypertension that compared telemedicine-based care with routine in-person management. Trials reporting changes in systolic and diastolic blood pressure were included. Literature searches were conducted in PubMed and EMBASE, and bibliographies were screened for studies published between 2013 and 2023. Two reviewers independently performed study selection, data extraction, and risk-of-bias assessment using the RoB-2 tool. Statistical analysis was conducted using RevMan 5.4, employing a random-effects model when heterogeneity ( I 2 > 50%) was detected. Results Of the 397 identified records, 5 randomized controlled trials met the eligibility criteria. The telemedicine interventions used across these studies included remote blood pressure monitoring, mobile health applications, and virtual consultations. When compared with standard care, telemedicine produced a statistically significant but clinically modest reduction in systolic blood pressure (mean difference: –1.55 mmHg; 95% confidence interval: –2.67 to –0.43; P = .007). There was no meaningful change in diastolic blood pressure (mean difference: 0.32 mmHg; 95% confidence interval: –1.59 to 2.22; P = .74). Several trials also reported secondary outcomes, including medication adherence, lifestyle modifications, and metabolic measures. Conclusion Telemedicine yielded a modest improvement in systolic blood pressure but did not demonstrate superiority over clinic-based care for diastolic blood pressure control. While it offers a valuable platform for improving access and continuity, evidence suggests its clinical advantage remains limited. Larger, rigorously designed studies are required to better understand long-term outcomes and feasibility in resource-constrained settings.