Charting the Future of Hypertension Care: Cardiowell’s Take on the Peterson Report

Cardiowell: Our Vision

I founded Cardiowell because I believe a fundamental truth in healthcare often goes overlooked: Patients can significantly reduce their dependence on medications when provided with the proper support and tools. However, many individuals with hypertension require prescription medication as part of their immediate treatment plan, at least initially. There’s an ideal balance between medical therapy, monitoring, and lifestyle changes that most clinicians fail to articulate clearly.

Medications play a pivotal role in bringing blood pressure down quickly, and the Peterson Health Technology Institute (PHTI) report highlights how effective they can be as a first line of defense. While I’m passionate about minimizing unnecessary medication use, I also acknowledge that sometimes these drugs are lifesavers—especially for people with dangerously high blood pressure. Still, we must not ignore that many hypertension meds come with serious side effects and frequent recalls. It’s also crucial to remember that hypertension can have a wide range of causes, from genetics to high-stress levels to limited access to healthy foods. Addressing those root causes takes time and usually requires comprehensive lifestyle adjustments.

Key Takeaways from the PHTI Assessment

The PHTI report groups digital hypertension solutions into Blood Pressure Monitoring, Medication Management, and Behavior Change.

1. Blood Pressure Monitoring

These systems transmit readings from home devices to a care team, offering more timely insights than the usual in-clinic checks. The trade-off is that monitoring alone provides only modest improvements—though it’s still better than nothing. I like to say, “Without the data, how do we know anything?” You can’t optimize medications with limited blood pressure data.

2. Medication Management

This is where you incorporate a virtual care team—nurses, pharmacists, and sometimes even physicians—who can adjust meds on the fly. The data so far show this approach delivers the most significant impact in the shortest time. To me, this underscores the need for genuinely personalized medication regimens. If we’re aiming to lower side effects and increase adherence, we must keep adjusting dosage and drug type until we find the sweet spot.

3. Behavior Change

Coaching, interactive reminders, and healthy habit reinforcement can help keep people on track. However, the research suggests that, when used by itself, it doesn’t knock down blood pressure as dramatically as a medication-focused strategy. However, I still see enormous value in behavior change tools because they attack the deeper reasons so many of us develop hypertension in the first place—diet, stress, and limited time to exercise. Put that together with a custom medication plan, and you can prevent long-term complications.

Medications as a First Line of Defense

The PHTI assessment shows that actively managing blood pressure with prescription drugs remains one of the most effective ways to achieve rapid systolic blood pressure (SBP) reductions. The data reveals that clinically meaningful outcomes—defined as lowering SBP by at least five mmHg—are most consistently reached by solutions focusing on Medication Management.

For many patients, that might look like adding or optimizing antihypertensive medications. Yet, it’s not a one-size-fits-all scenario. Some blood pressure meds have significant side effects or have seen concerning recalls. For me, that underscores the importance of using low-dose formularies combined with patient-specific data so each individual receives the most appropriate dose—and, ideally, avoids unnecessary complications.

Why a Personalized, Low-Dose Approach Matters

For those of us who’ve spent time on this issue, strong medication adherence is essential—without it, even the most well-intentioned treatment plan fizzles out. I love digital solutions that blend remote blood pressure monitoring with real-time reminders and user-friendly education. When patients understand the why behind their medication, they’re far likelier to follow through.

Why Remote Monitoring Matters So Much

While prescription drugs tend to get all the hype, monitoring blood pressure at home is a crucial and complementary piece of the puzzle. Consistent insight into a patient’s readings throughout the day allows clinicians (or digital care teams) to optimize medication dosage in near real time.

'What gets measured gets changed' – Peter Drucker

That quote rings especially true here. Consistent, at-home monitoring does more than track numbers; it changes patient behavior. Research shows self-monitoring alone can lower blood pressure by up to 9 mmHg—even before you layer on major medication adjustments or coaching. The reason is straightforward: checking your blood pressure regularly helps you see the consequences of everyday choices, from diet to stress management. When people know they’ll see a reading that reflects last night’s high-sodium takeout, they’re more likely to adjust future decisions.

Why Social Determinants of Health Aren’t Optional

Of course, hypertension doesn’t exist in a vacuum. Access to nutritious foods, safe places to exercise, reliable transportation, and stable housing all factor into whether someone gets diagnosed early, stays on treatment and maintains healthy blood pressure. This is why Cardiowell includes social determinants of health (SDOH) in our approach. It’s not enough to watch numbers on a screen; we must understand each patient's reality.

The PHTI report confirms what many have observed: digital solutions that account for a person’s environment, daily stressors, and support systems see better results. Medication alone can’t offset a lack of healthy food or safe neighborhoods to walk in.

The Investment Challenge: Three Years vs. Ten

Effectively managing hypertension can be expensive. The PHTI findings show that digital hypertension management solutions often increase total spending over the initial three years, particularly those emphasizing robust medication management. Thanks to reduced cardiovascular events and lower healthcare utilization, it may take ten years on average to recoup these costs.

That’s a tough sell for commercial payers because they typically only retain members for about three years. Yet, if we can align incentives via value-based payment models or multi-year contracts, it suddenly makes more sense to commit to solutions with long-term benefits - especially for Medicare patients. See Exhibit 22, which shows a ten-year Medicare cost savings of $64M and 133M for blood pressure monitoring and medication management, assuming a 25% utilization in a one million-member plan over a 10-year period. Read the referenced citation for details.

A Comprehensive Solution for Long-Term Success

The big lesson from PHTI is that medication management is indispensable in the short run—it can swiftly bring blood pressure into a safer range. Still, we want patients to eventually thrive on sustainable lifestyle changes, better eating habits, effective stress-coping strategies, and the latest wearable technology. Coupling personalized prescribing and remote monitoring with a deep understanding of social factors makes you see more substantial, more durable results.

Where We Go From Here

Coupling personalized prescribing and remote monitoring with a deep understanding of social factors makes you see more substantial, more durable results. Even better, some patients might be able to taper down certain medications when it’s safe and appropriate. Addressing hypertension at scale demands, we keep innovating on several fronts: more advanced monitoring devices, better alignment with value-based payment models (to cover that up-front investment for longer-term returns), and more robust clinical evidence to guide best practices. For those of us in digital health, this represents a huge opportunity—and responsibility. By gathering more data, personalizing medications, and scaling access to coaching, we’re not just chipping away at America’s blood pressure crisis but also laying the groundwork for a more patient-centric system.

Addressing hypertension at scale demands a multi-pronged approach:

1. More Advanced Monitoring Tools

Continuous blood pressure monitoring—via wristbands or patches—transforms sporadic checkups into a steady stream of actionable data.

2. Alignment with Value-Based Payment Models

If payers and providers share the risk and reward, they’re far more likely to invest in solutions that pay dividends over a decade rather than just three years.

3. Robust Clinical Evidence

Ongoing research helps us understand which interventions work best for which populations, ensuring we allocate our resources wisely.

4. Personalized Medication and Coaching

Yes, meds can be life-saving. But they can also be fine-tuned so side effects go down, and adherence goes up—especially with real-time data from wearables. Meanwhile, sustained lifestyle changes tackle the root causes.

5. Holistic View of the Patient

Let’s factor in social determinants of health, psychological stressors, and each patient’s unique environment. That’s how we design programs that lead to long-term control.

Ultimately, the Peterson assessment reminds me why I started Cardiowell in the first place: to empower people with the right balance of data-driven technology and support. Yes, drugs can be lifesaving. Yes, they can also be fine-tuned so that side effects go down and adherence goes up. And yes, lifestyle changes matter because they tackle many root causes. I hope we keep fusing these elements so that soon, more patients can realistically reduce—or even eliminate—their reliance on unnecessary meds while maintaining blood pressure control. We are here to help. - Yair Lurie

Want to Learn More?

Feel free to reach out if you’re curious how Cardiowell—or any of these digital innovations—can elevate your hypertension program. After all, it’s your health data—let’s use it to bring those numbers down and keep them there