hypertension, heart disease apps help with earlier diagnosis and faster treatment
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do you have high blood pressure? what if you could skip the visits to your doctor and get your blood pressure managed by a care team through an app on your smartphone?
thanks to tech advancements, mobile phones not only keep you plugged into email and social media, they are becoming vital tools for diagnosing your health and real-time monitoring of risk factors.
bbc recently reported on the signs of heart disease that smartphones can spot, including blood clotting that can trigger heart attacks. scientists at the university of washington have used the iphone’s lidar, the light detecting and ranging sensor, to detect clotting in a single drop of blood. this is testing that a doctor usually would do with a full syringe of blood, but now the potential is there for someone to test at home with their smartphone.
the sensor produces pulsed beams of light to give you 3d images of your surroundings. researchers put a droplet of blood on a glass slide and the lidar laser pulses produce “speckle patterns” where there is coagulation in the blood.
there are also algorithms in development that analyze self-shot smartphone videos to detect almost imperceptible changes in facial blood flow, and selfies of a person’s face that show changes like wrinkles and fatty deposits under the skin in the cheeks, nose and forehead. researchers say these can help identify patients who need further investigation for heart disease risk.
monitoring high blood pressure
an american start-up, riva health, also now has a heart-helper app on the market that tracks blood pressure using a smartphone’s camera and camera flash. experts say the readings are precise enough to be relied on by doctors.
siri cofounder dag kittlaus and bioengineer tuhin sinha are the leaders behind the company that wants to help people measure their blood pressure in a clinically approved way, unlike other devices like blood pressure cuffs and cuffless wearables that are for nonclinical use and not highly accurate. the riva team worked with partners, including uchealth and the university of colorado innovation fund, to bring medical-grade measuring to everyday smartphones.
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“you put your index finger on the camera on your phone and it measures your pulse wave form,” says dr. richard zane, chief innovation office at uchealth and chair of emergency medicine at the university of colorado school of medicine.
although your fingertip is a long way from your heart, it has a lot of arteries and a large amount of blood flow. this large amount of blood is your ‘pulse wave form’ — a measure of blood pressure — and it gives doctors a better sense of how hard your heart is working. the pressure reading is captured using the camera flash.
“your pulse wave form is actually a more accurate measure of blood pressure than a sphygmomanometer, which is sort of an old-fashioned cuff,” zane says.
high blood pressure is the leading risk of death
according to heart and stroke, increased blood pressure, or hypertension, is the leading risk for death in countries like canada. six million canadian adults have high blood pressure, representing 19 per cent of the adult population. of those, 17 per cent are unaware of their condition.
and only about a fourth of people with high blood pressure have it under control. part of the problem is because sphygmomanometers, used in a doctor’s office or at home, don’t provide a steady stream of blood pressure readings, at different times and in a variety of settings during the day, which can help determine the most effective treatment.
zane says that this is where riva health stands out with the ability for frequent monitoring and accurate data that goes directly to a concierge care team, including a pharmacist and doctor, that direct a lifestyle and medication plan personalized to you. plus, people can access care without having to wait.
“what’s so elegant about riva is that it uses ai-based technology, it uses smartphones that almost everyone has in their back pocket, and then it has the right level of person involved at the right level of decisions with this team of specialists,” he explains, adding that users connect not only with a pharmacist who manages hypertension, but also a nutrition who does as well.
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for patients, it means earlier detection of possible problems and intervention, which ultimately leads to fewer heart attacks, strokes and kidney transplants.
remote-monitoring a priority for cardiac care
this patient-centred approach is also a priority for cardiac care teams in canada where remote monitoring apps have played an increasingly important role with the pandemic’s shift to telemedicine.
tina carriere, a cardiac nurse at the university health network’s peter munk cardiac centre in toronto, has seen the benefits of the medly app that allows heart failure patients to submit daily readings and receive instant feedback on their care.
“heart failure is a chronic condition, and so not only are the patients treated with medications or other medical therapy, they have to maintain lifestyle restrictions with regards to their fluid and sodium intake and it’s a huge challenge,” she says.
carriere, who also works as a nurse coordinator for the medly program and is responsible for helping patients use the app, adds that the technology provides patients with the tools and guidance they need to to take an active role in the management of their heart failure, and stay connected to their heart failure team.
before medly was introduced, patients diagnosed with heart failure would need to be seen repeatedly in the clinic for the guideline-directed medical therapy, blood work and medication adjustments. this meant travelling to the clinic and relying on family members to accompany them. the frequency of appointments also proved challenging for patients with mobility issues or those coming from other cities.
now, about 750 patients at peter munk have downloaded the app on their smartphone or tablet. they enter information on daily weight, blood pressure and heart rate and respond to the app’s questions on symptoms they may be experiencing, such as worsening shortness of breath, swelling ankles or unexplained fatigue — common signs of heart failure. the information is processed by the medly algorithm and flags the nurse coordinator to respond to the patient and connect them to the cardiac team if needed.
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“it has really removed the barrier to access of care which can be quite significant depending on patients’ physical location, and it helps them to take control of their health and advocate for themselves,” carriere says, adding that another benefit is having family members get more involved in care for additional support.
she encourages anyone with heart disease in the family to check out the heart hub, the peter munk information and resource portal.
“we are able to provide that early intervention, which decreases the amount of er visits for urgent treatment and the potential for a hospital admission,” she says. “i feel so honoured to be part of this program because of the number of patients that we can help not only live with heart failure, but live their best life.”
karen hawthorne is a toronto-based writer.
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