Closing the gap: managing high blood pressure after an ER visit
Leaving the emergency room with dangerously high blood pressure can feel overwhelming. For many patients, the support ends the moment they walk out the door. A new pilot program at the University of Alabama at Birmingham (UAB) is changing that by helping patients take charge of their health from home.
High blood pressure, or hypertension, happens when blood flows through your arteries with too much force, putting stress on your heart and blood vessels. Without timely care, patients discharged from the hospital with high blood pressure can face serious health risks, including strokes or repeated hospital visits.
World Hypertension Day, observed on May 17, highlighted the need for better blood pressure management worldwide. That urgency is at the heart of the “Post-Emergency Department Telehealth Follow-Up Program”, led by Lama Ghazi, M.D., Ph.D., assistant professor of epidemiology at UAB. The project offers personalized, tech-enabled support to help patients safely recover and stay out of the hospital.
Who Is participating?
The study successfully enrolled 40 adults aged 30–75 discharged from UAB’s emergency department (ED) with very high blood pressure (systolic readings of 160 mm Hg or higher). All participants live within 30 miles of the hospital, speak English or Spanish, and use a home blood-pressure monitor, with support available from caregivers as needed.
What does the program involve?
Participants receive home blood-pressure monitors along with comprehensive training. Nurses teach participants and caregivers how to measure and record their blood pressure accurately.
Lama Ghazi, M.D., Ph.D.
Assistant Professor, University of Alabama at Birmingham
Did You Know?
Hypertension, or high blood pressure, significantly increases the risk of heart disease and stroke. Regular monitoring can help control it.
Each week, participants connect virtually with a nurse-pharmacist team through phone or video calls. During these telehealth sessions, the team reviews blood-pressure readings, adjusts medications according to set guidelines, and addresses participants’ health questions.
Automated text reminders twice a week prompt participants to take their blood pressure and submit readings via text or phone calls. Pharmacists also help participants address medication-related challenges, such as affordability, by connecting them to discount programs and local healthcare services.
Early signs of progress
While full evaluation is ongoing, early trends from the pilot phase suggest the program is having a positive impact.
Blood Pressure Improvement (90-day follow-up):
- Participants experienced an average systolic drop of 16 points (from 162 to 146 mm Hg).
- Diastolic readings fell by an average of 9 points (from 94 to 85 mm Hg).
Reduced Return Visits:
- Participants had 22% fewer ED visits within 30 days compared to similar patients who received standard care.
Strong Participation:
- Nearly all scheduled telehealth check-ins were completed, with 95% of visits attended.
Positive Experience:
- Most participants shared high levels of satisfaction with the support they received.
- Many found the reminder texts easy to use and helpful in staying on track.
These preliminary results will help inform the next phase of the program, which continues to assess longer-term outcomes.
Recognizing the importance of digital literacy, the program introduced a 15-minute “tech check” call at the beginning to boost early engagement. Additionally, new Spanish-language tech guides introduced in March 2025 expanded access and helped ensure more participants could comfortably utilize and understand the materials.
What’s next?
The team will complete 180-day blood-pressure and quality-of-life assessments by mid-June 2025. A cost-effectiveness analysis is scheduled to begin in July, and expansion into two UAB community clinics is planned for late 2025. These next steps aim to evaluate long-term impacts on health outcomes and overall cost efficiency.
By combining user-friendly home monitoring, consistent virtual check-ins, and accessible medication support, Ghazi’s pilot demonstrates a practical approach to managing high blood pressure, potentially preventing severe health complications such as stroke.
Key Terms to Know
-
Hypertension: Persistently high blood pressure.
-
Telehealth: Remote healthcare provided through phone or video calls.
-
Systolic and Diastolic: Systolic (top number) measures pressure when your heart beats; diastolic (bottom number) measures pressure between beats.
