Abstract Details

Title Digital Health and Wearable Technologies for Blood Pressure Management in Secondary Stroke Prevention

Topic Cerebrovascular Disease and Interventional Neurology

Presentation(s) S25 - Emerging Stroke Therapies and Risk Stratification (1:24 PM-1:36 PM)

Poster/Presentation
Number 003

Objective To evaluate the effectiveness of digital health and wearable technology interventions on blood pressure (BP) control among stroke survivors.

Background Hypertension is a major modifiable risk factor for recurrent stroke. Digital health technologies, such as home BP monitors and smartphone applications, offer scalable solutions for continuous BP tracking and personalized management.

Design/Methods We systematically searched MEDLINE, Embase, and CENTRAL (inception–September 2025) for studies involving adults with prior stroke or transient ischemic attack using wearable or digital health tools for secondary prevention. Randomized clinical trials (RCTs), single-arm interventional, and observational studies were included. Random-effects meta-analyses were performed using DerSimonian–Laird methods. Risk of bias was assessed using RoB-2 and ROBINS-I.

Results Fourteen studies (n=1,783 total; mean age 58 years; 39% women) reported BP outcomes, including nine RCTs. Most interventions combined home BP monitoring with education, reminders, and clinician feedback. Across seven studies with compatible data, digital health–interventions reduced SBP by –6.17 mmHg (95% CI: -12.96 to 0.62) and DBP by –0.49 mmHg (95% CI: 4.62-3.63). Consistent within-arm reductions and higher BP control rates were seen in non-pooled studies. Studies integrating remote monitoring with structured medication titration or clinician follow-up achieved the largest within-arm SBP reductions (≈ 8–12 mm Hg) and the highest BP-control rates (> 60 %), whereas passive monitoring alone produced smaller effects. There was a nonsignificant trend toward larger BP reduction with higher starting BP (slope = −0.34 mm Hg per 1 mm Hg baseline; 95 % CI: −1.67-0.99; k = 7). Heterogeneity was high (I²=87%), reflecting variability in intervention intensity and device type.

Conclusions

Digital health–enabled BP monitoring modestly improves systolic BP among stroke survivors, with the greatest impact in structured “monitor and manage” models. While heterogeneity and small study sizes limit certainty, the results suggest potential effectiveness of such interventions in secondary stroke prevention.

Authors/Disclosures
Shervin Badihian, MD (Cleveland Clinic) PRESENTER	Dr. Badihian has nothing to disclose.
Margarita Fedorova, MD (Electric Gardens)	Ms. Fedorova has nothing to disclose.
Bradley G. Ong, MD (Cleveland Clinic Main Campus - Neurological Institute)	The institution of Dr. Ong has received research support from ��ɫ��. Dr. Ong has a non-compensated relationship as a Editorial Board Member with Neurology Resident & Fellow Section that is relevant to AAN interests or activities. Dr. Ong has a non-compensated relationship as a Contributor with Neurology Minute that is relevant to AAN interests or activities.
Neil Nero, MLIS	Mr. Nero has nothing to disclose.
Ken Uchino, MD (Cleveland Clinic Foundation)	Dr. Uchino has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Aboott Laboratories, Inc.. Dr. Uchino has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for ACP JOURNAL CLUB. The institution of Dr. Uchino has received research support from NIH.
Shumei Man, MD, PhD (Neurological Institute, Cleveland Clinic)	No disclosure on file

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