Clinical Practice

Intensive care medicine

Health care

Clinical trial

Economics

Ambulatory

Prehypertension

Blood pressure

Physical therapy

Ambulatory blood pressure

Masked Hypertension

Internal medicine

Medicine

Economic growth

Reimbursement

Disease

Randomized controlled trial

Hypertension Research

In 2021, the open-label randomized HERB-Digital Hypertension 1 (HERB-DH1) trial showed for the first time that hypertension digital therapeutics (a hypertension treatment app) successfully reduced blood pressure (BP) in patients with hypertension. Patients in the digital therapeutics group who used the app and home BP monitoring (HBPM) showed significant and persistent decreases in office, home and ambulatory BP values compared with the control group (who were under physician management using HBPM and lifestyle modifications). The results of the pivotal study led to the first global approval of this app for the treatment of hypertension in Japan in 2022, including medical insurance reimbursement. As a result, this hypertension app is expected to become widely used in the clinical management of all stages of hypertension. The most important remaining research issues include the identification of patients likely to respond to this therapeutic approach and the development of clinical efficacy indices. In addition, guidelines for the appropriate use of hypertension apps in the treatment of hypertension are needed. Next steps include the development and research of digital tools to facilitate the behavioral modifications required to prevent hypertension. Home BP-guided digital approach to prevent the onset of hypertension and its consequences from prehypertension to severe hypertension. SaMD, software of medical device; CVD, cardiovascular disease

The first software as medical device of evidence-based hypertension digital therapeutics for clinical practice