Remote patient monitoring (RPM) for hypertension enables automatic transmission of blood pressure (BP) and pulse into the electronic health record (EHR), but its effectiveness in primary care is unknown. This pragmatic matched cohort study using EHR data compared BP outcomes between individuals prescribed RPM and temporally-matched controls from six primary care practices. We retrospectively created a cohort of 288 Medicare-enrolled patients prescribed BP RPM (cases) and 1152 propensity score-matched controls (1:4). Matching was based on age, sex, systolic blood pressure (SBP), marital status, and other characteristics. Outcomes at 3, 6, 9 and 12 months were: controlling high BP (most recent BP < 140/90 mm Hg), antihypertensive medication intensification, and most recent SBP assessed using: all measurements, and office measurements only. At baseline, RPM-prescribed patients and controls had similar ages and systolic BP. BP control diverged at 3 months (RPM: 72.2%, control: 51%, p < 0.001). This difference persisted but decreased over follow-up. After 12 months, the RPM-prescribed cohort had greater BP control (RPM: 71.5%, control: 58.1%, p < 0.001) and lower SBP (132.3 versus 136.5 mm Hg, p = 0.003) using all measurements, but they did not differ using only office measurements (12 month BP control: 60.8% versus 58.1%, p = 0.44; SBP: 135.9 versus 136.5 mm Hg, p = 0.91). At 12 months, the most recent BP measurements were more current for RPM-prescribed patients (median [IQR] 8 [0–109] versus 134 [56–239] days). Net increases in antihypertensive medications by 12 months were similar. Implementation of RPM in primary care could inform hypertension management strategies and increase hypertension control. Registration: ClinicalTrials.gov identifier: NCT05562921.

高血压远程患者监测 (RPM) 可以将血压 (BP) 和脉搏自动传输到电子健康记录 (EHR) 中，但其在初级保健中的有效性尚不清楚。这项实用的匹配队列研究使用 EHR 数据，比较了处方 RPM 的个体和来自六个初级保健实践的时间匹配对照之间的血压结果。我们回顾性地创建了一个由 288 名参加 Medicare 且接受 BP RPM 治疗的患者（病例）和 1152 名倾向评分匹配对照者 (1:4) 组成的队列。匹配基于年龄、性别、收缩压（SBP）、婚姻状况和其他特征。3、6、9 和 12 个月的结果为：控制高血压（最近血压 < 140/90 mm Hg）、抗高血压药物强化以及最近的 SBP 评估使用：所有测量值和仅办公室测量值。在基线时，接受 RPM 处方的患者和对照组具有相似的年龄和收缩压。血压控制在 3 个月时出现分歧（RPM：72.2%，对照：51%，p  < 0.001）。这种差异仍然存在，但在随访过程中有所减少。12 个月后，使用 RPM 处方的队列使用所有测量值具有更好的血压控制（RPM：71.5％，对照：58.1％，p  < 0.001）和更低的 SBP（132.3 与 136.5 mm Hg，p  = 0.003），但他们并没有仅使用诊室测量结果存在差异（12 个月血压控制：60.8% 与 58.1%，p  = 0.44；SBP：135.9 与 136.5 mm Hg，p  = 0.91）。12 个月时，服用 RPM 处方的患者最近一次血压测量更为及时（中位 [IQR] 8 [0–109] 天 vs 134 [56–239] 天）。12 个月内抗高血压药物的净增加量相似。在初级保健中实施 RPM 可以为高血压管理策略提供信息并加强高血压控制。注册：ClinicalTrials.gov 标识符：NCT05562921。