Do Self-Measured Blood Pressure Devices Change Outcomes?: Implementation Does: Team-Based Insights from the ASPIRE Hybrid Trial

Hypertension remains one of the most important modifiable risk factors for developing cardiovascular events and associated mortality. The global prevalence of hypertension in 2019 was estimated to be 30% in those aged 30–79, and affects more than 1.3 billion individuals.1 However, many are unaware, untreated, or undertreated. Hypertension control is particularly weak in low- and middle-income countries (LMICs), with a control rate of around 10%, due to structural barriers to primary care, limited access to validated devices, and interruptions in care. However, even in high-income countries, optimal blood pressure control is only achieved in about 40% of patients.1 In particular, socioeconomically disadvantaged populations, including racial and ethnic minorities and individuals, such as those insured through Medicaid in the USA, exhibit disproportionately poor hypertension outcomes.