AI-driven health app helps patients achieve better blood pressure control

Incorporating a free smartphone app featuring AI-driven health coaching, blood pressure monitoring, and behavioral incentives into a hospital's existing clinical workflows helps patients make meaningful reductions in blood pressure, findings that suggest that digital apps may offer an effective means of extending care beyond the clinic when incorporated into treatment plans. 

In a study published in the Journal of General Internal Medicine, Rush University Medical Center clinicians described how a group of 425 patients already being treated for high blood pressure used a free smartphone app to make at-home condition management and adoption of healthy habits easier.  Developed by Nuna, Inc., the app helps users track blood pressure readings and maintain a heart-healthy lifestyle via personalized reminders while also allowing healthcare providers a window into patients' efforts in between visits. 

"The group that incorporated the Nuna app into their care showed clinically significant improvements. While the study wasn't designed to assess hard clinical outcomes, established research has shown a direct correlation between reductions of this magnitude and lower rates of heart attacks and strokes," said Michael Gottlieb, MD, MBA, a Rush emergency medicine physician, vice chair of research, and the study's co-lead author.  "But well before we were able to process and assess the impact of the app as researchers, as physicians we were able to see –patient by patient – the power of a tool that empowers patients to manage their blood pressure every day."  

During the year-long study, patients being treated for high blood pressure at Rush who agreed to incorporate the use of the app as part of their care had their systolic blood pressure (SBP) and diastolic blood pressure (DBP) readings tracked for six months and then compared to their baseline readings six months prior to starting to use the app.  Their results were then compared with a control group of 425 demographically similar patients who did not use the app as part of their high blood pressure treatment. While the control group lowered blood pressure consistent with expected outcomes for their treatment, the group that also used the Nuna app had even greater reductions, especially among participants whose blood pressure numbers passed the threshold between readings deemed "uncontrolled" and not just "high."   

The data shows, for example, that among participants with uncontrolled stage 2 hypertension at baseline, their systolic blood pressure (the top number in reading), decreased by 13.6 mmHg among app users compared with 9.0 mmHg among controls.  Kristin Pallok, MD, a Rush internal medicine specialist and study's co-lead author noted that seeing such a marked difference in the progress made by the group that used Nuna compared to the control group is "very encouraging.  The data reflects what patient after patient has been telling us: using the app has helped them take better control of their health." 

Hypertension – or high blood pressure-- is among the nation's most modifiable risk factors for cardiovascular disease, stroke, chronic kidney disease, and premature mortality, as nearly half of adults meet diagnostic criteria for hypertension.  The Centers for Disease Control and Prevention estimates that uncontrolled high blood pressure costs the country nearly $200 billion in healthcare costs alone. But despite decades of advances in pharmacologic therapy and well-established evidence-based treatment guidelines, fewer than 25% of adults with hypertension achieve adequate blood pressure control. 

"Nuna helps us understand what happens outside of the clinic walls. It's not a snapshot in time like clinic visit, but rather a window into a patient's daily routine and blood control progress," said Pallok. "We know long-term damage in cardiovascular disease is an accumulation of your risk over time, and now we can communicate more proactive treatment adjustments faster. Instead of lowering a patient's risk over a period of months, we can do it in weeks."  She added.         

"The medication adherence and lifestyle changes needed to keep high blood pressure under control can be very difficult to sustain.  While physicians would love to stay steadily engaged with patients, realistically we only see them every few months and then only have that day's reading and patient recollection. It's a shared frustration," Pallok added. 

A Rush community health worker suggested "Daniel," a young man with extremely high blood pressure and other health challenges, begin using the app.  After a few weeks, he replied in an app survey that "his new friend, Nuna" had coaxed him into daily walks and giving up salt. 

Rush and Nuna's partnership began when Jini Kim, Nuna's CEO and co-founder, met Dr. Omar Lateef, President & CEO of Rush University System for Health and Lateef described a frustration familiar across the industry: despite strong quality scores on blood pressure control, Rush struggled to reach targets among its historically difficult-to-engage patient populations. Kim recognized this problem. "Nuna was founded to improve outcomes through value-based care, but outcomes were limited by physicians' reach outside of the clinic," Kim stated. "We knew that we needed to address this gap." 

Source:

Rush University Medical Center

Journal reference:

https://link.springer.com/article/10.1007/s11606-026-10684-0