{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,26]],"date-time":"2026-10-26T13:19:57Z","timestamp":1793020797882,"version":"4.5.0"},"reference-count":25,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2022,9,24]],"date-time":"2022-09-24T00:00:00Z","timestamp":1663977600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Cardiology"],"published-print":{"date-parts":[[2022,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Hypertension is the leading risk factor for death, affecting over one\u00a0billion people worldwide, yet control rates are poor and stagnant. We developed a remote hypertension management program that leverages digitally transmitted home blood pressure (BP) measurements, algorithmic care pathways, and patient\u2013navigator communications to aid patients in achieving guideline\u2010directed BP goals.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Patients with uncontrolled hypertension are identified through provider referrals and electronic health record screening aided by population health managers within the Mass General Brigham (MGB) health system. Non\u2010licensed patient navigators supervised by pharmacists, nurse practitioners, and physicians engage and educate patients. Patients receive cellular or Bluetooth\u2010enabled BP devices with which they monitor and transmit scheduled home BP readings. Evidence\u2010based medication changes are made according to a custom hypertension algorithm approved within a collaborative drug therapy management (CDTM) agreement with MGB\u00a0and implemented by pharmacists.<\/jats:p><jats:p>Using patient\u2010specific characteristics, we developed different pathways to optimize medication regimens. The renin\u2013angiotensin\u2013aldosterone system\u2010blocker pathway prescribed ARBs\/ACE inhibitors first for patients with diabetes, impaired renal function, and microalbuminuria; the standard pathway started patients on calcium channel blockers. Regimens were escalated frequently, adding thiazide\u2010type diuretics, and including beta blockers and mineralocorticoid receptor antagonists if needed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion<\/jats:title><jats:p>We have developed an algorithmic approach for the remote management of hypertension with demonstrated success. A focus on algorithmic decision\u2010making streamlines tasks and responsibilities, easing the potential for scalability of this model. As the backbone of our remote management program, this clinical algorithm can improve BP control and innovate the management of hypertension in large populations.<\/jats:p><\/jats:sec>","DOI":"10.1002\/clc.23919","type":"journal-article","created":{"date-parts":[[2022,9,25]],"date-time":"2022-09-25T05:14:30Z","timestamp":1664082870000},"page":"1147-1162","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["A remote hypertension management program clinical algorithm"],"prefix":"10.1002","volume":"45","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2119-6140","authenticated-orcid":false,"given":"Hunter","family":"Nichols","sequence":"first","affiliation":[{"name":"Division of Cardiovascular Medicine Boston Massachusetts USA"},{"name":"Department of Pharmacy Services Boston Massachusetts USA"},{"name":"Brigham and Women's Hospital Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4596-2791","authenticated-orcid":false,"given":"Christopher P.","family":"Cannon","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine Boston Massachusetts USA"},{"name":"Brigham and Women's Hospital Boston Massachusetts USA"},{"name":"Harvard Medical School Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benjamin M.","family":"Scirica","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine Boston Massachusetts USA"},{"name":"Brigham and Women's Hospital Boston Massachusetts USA"},{"name":"Harvard Medical School Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1649-1441","authenticated-orcid":false,"given":"Naomi D. 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