We’ve spent over two years working, evaluating, and writing about Biobeat’s remarkable cuffless blood pressure sensors and remote patient monitoring technologies. Their latest products, 24BP and ABPM leverage their earlier successes to take on the most tragically intractable health problem we face, hypertension, and, by extension, cardiovascular disease. It’s worth recapping the numbers and illuminating the tragedy to put hypertension in proper context. In the US:
116 million or 47% of adults live with hypertension[1].
Despite billions spent on education, research, and new drugs, less than one in four hypertensives have their blood pressure under control[2].
About 30% of patients quit diagnostic protocols before completing them and about 50% stop taking their blood pressure medications within a year of being prescribed[3].
670,000 (2020) or about 20% of deaths list hypertension as a primary or secondary cause[4].
Each year, hundreds of thousands of hypertensive stroke survivors are left with significant disabilities[5].
Economic costs are estimated between 103 and 200 billion dollars per year.
Our reviews of the literature and discussions with clinicians suggest that these numbers have been accepted and normalized within the medical community. Doctors don't ignore hypertension, but there are few expectations that the numbers above will measurably change anytime soon. Normalization is aided by the stultifying slow pace of technological advancements and innovations in blood pressure instruments since they entered service around 1920. Specifically, while there have been improvements in materials and ease of use, cuff-based instruments in 2022 deliver the same clinically relevant information as those in use in 1920 - a century before.
Viewed from patients’ frames of reference, legacy hypertension diagnostic technologies, protocols, and treatment strategies suffer from high treatment burden (uncomfortable, disruptive, time-consuming, and costly) and low efficacy[7],[8]. Studies show that most hypertensives vote with their feet and quickly turn away from their doctors’ advice. Contrary to assertions in the literature, patient decision-making and decisions are rational and thus difficult to influence through outreach and education alone. Their behaviors mirror those of customers across the broader economy who consistently turn their backs on products and services that are similarly cumbersome, time-consuming, expensive, and ineffective.
Our upcoming posts will focus on how new technologies like Biobeat’s revolutionary cuffless sensors and similarly innovative care delivery models can be leveraged to reduce treatment burden and improve efficacy. Together, they represent the first practical opportunity in nearly a century to reduce hypertension’s trajectory and tragic toll.
References
Centers for Disease Control and Prevention. Hypertension Cascade: Hypertension Prevalence, Treatment and Control Estimates Among U.S. Adults Aged 18 Years and Older Applying the Criteria from the American College of Cardiology and American Heart Association’s 2017 Hypertension Guideline—NHANES 2015–2018. Atlanta, GA: U.S. Department of Health and Human Services; 2021.
ibid.
Michael Burnier, Brent M. Egan, Adherence in hypertension, AHA Journals, March 28, 2019, https://www.ahajournals.org/doi/10.1161/CIRCRESAHA.118.313220#
Centers for Disease Control and Prevention, National Center for Health Statistics. About Multiple Cause of Death, 1999–2020. CDC WONDER Online Database website. Atlanta, GA: Centers for Disease Control and Prevention; 2022. Accessed August 3, 2022.
Stroke Facts, Centers for Disease Control and Prevention, https://www.cdc.gov/stroke/facts.htm, accessed September 5, 2022.
Estimates vary depending on primary and secondary effects on patients and the economy. The lower estimate is based CDC published information and referenced studies including Kirkland EB, Heincelman M, Bishu KG, et. al. Trends in healthcare expenditures among US adults with hypertension: national estimates, 2003-2014. J Am Heart Assoc. 2018;7:e008731.
Jeremy B. Sussman, MD, MSc, Greggory J. Schell, PhD, Mariel S. Lavieri, PhD, Implications of True and Perceived Treatment Burden on Cardiovascular Medication Use, SAGE Journals, December 22, 2017. https://journals.sagepub.com/doi/10.1177/2381468317735306
Estimated Hypertension Prevalence, Treatment, and Control Among U.S. Adults, Million Hearts, https://millionhearts.hhs.gov/data-reports/hypertension-prevalence.html, accessed September 9, 2022.