Strengths and limitations
hypertension
HYPERTENSION, RECRUITMENT
This study was conducted in primary care settings, which makes the results highly relevant for real-life hypertension management, as the vast majority of patients with hypertension are treated in primary care in Sweden. It was a large study, including patients and professionals from different regions and socioeconomic areas. By following the patients for 1 year, the long-term effects could be studied.There is a risk of recruitment bias in a study like this. The patients may have chosen to participate as they already have an interest in health-related issues and a motivation to change their lifestyle. Even though efforts were made to include patients regardless of previous technical knowledge and experience, there is a risk that patients who are unaccustomed to technical systems or using mobile phones declined to participate. More than 95% of the participants originated from Sweden, thus we are unsure if the results are applicable in a more heterogenic population. This may be because of the inclusion criterion of sufficient understanding of the Swedish language, which was necessary to utilize the system at present. If the system becomes available in other languages, more patients may be able to use it.In conclusion, the proportion of participants with a controlled BP of less than 140/90 mmHg increased after using the interactive system for self-management of hypertension for 8 weeks, compared with usual care. The trend continued after 12 months, although the difference between the groups decreased and was no longer significant. The results indicate that the effect of the intervention is significant, but the long-term effect is uncertain.