Remote Digital Monitoring to Assess Daily Blood Pressure after Hospitalization for Stroke
Karishma Popli1, Vincent Rogalski1, Amelia Tenberg1, Mona Bahouth2, Steven Zeiler1
1Department of Neurology, Johns Hopkins University School of Medicine, 2Department of Neurology, Johns Hopkins School of Medicine
Objective:

This study evaluated post-stroke blood pressure trends using a commercially available remote digital monitoring platform.

Background:
Prior stroke and transient ischemic attack (TIA) markedly increase the risk of recurrence. Blood pressure (BP) control is central to secondary prevention, yet post-discharge management is often suboptimal. Remote digital monitoring (RDM) may improve BP management through real-time data collection and patient engagement.
Design/Methods:

In this prospective, single-center study, 60 patients with ischemic stroke, hemorrhagic stroke, or TIA discharged home were enrolled. The study was funded by Harman, which also provided the monitoring equipment. Each participant received an RDM kit consisting of a Samsung Galaxy tablet, FDA-approved Bluetooth BP cuff, and smartwatch for heart rate and step tracking. Patients were instructed to measure BP daily and were contacted at weeks 1, 4, and 8 for engagement assessment. Data were transmitted to a cloud-based platform accessible to clinicians. The analysis focused on BP trends and follow-up duration.

Results:

The mean age was 57 years, and 58% were women. Qualifying events included ischemic stroke (68%), hemorrhagic stroke (22%), and TIA (10%). Forty-four participants (73%) engaged with the RDM platform, while 16 (27%) did not transmit data as instructed. Among active users, mean baseline BP at stroke admission was 155/87 mmHg, which decreased to 128/79 mmHg after two weeks of monitoring and 127/78 mmHg over 15 weeks. Over half (55%) of engaged participants continued monitoring up to 10 weeks post-discharge.

Conclusions:

Integration of RDM into post-stroke care was associated with improved BP control consistent with AHA-recommended targets. These findings suggest RDM may support secondary stroke prevention through consistent monitoring and patient engagement. Future studies should assess long-term adherence, predictors of engagement, and the impact of RDM on recurrent stroke and readmissions.

10.1212/WNL.0000000000215631
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