Telemedicina y monitoreo remoto para superar la inercia terapéutica en el control de la hipertensión arterial: Una revisión integrativa
Keywords:
Hipertensión, Telemedicina, Monitoreo remoto de pacientes, Inercia terapéutica, Salud móvil, Revisión integrativaAbstract
Introducción: La hipertensión arterial sigue siendo un desafío global caracterizado por tasas de control subóptimas y una alta prevalencia de inercia terapéutica. La transformación digital ofrece nuevas vías para optimizar el manejo clínico. El objetivo de este estudio fue analizar la evidencia sobre la eficacia de la telemedicina y el monitoreo remoto en el control de la presión arterial (PA), la adherencia terapéutica y la utilización de recursos sanitarios.
Métodos: Se realizó una revisión integrativa de la literatura siguiendo el marco de Whittemore y Knafl. Se llevaron a cabo búsquedas exhaustivas en PubMed, Scopus, Web of Science y Google Scholar de artículos publicados entre 2015 y 2025. Se incluyeron ensayos clínicos, estudios observacionales y revisiones sistemáticas. Los hallazgos se sintetizaron temáticamente en eficacia clínica, impacto conductual, innovaciones tecnológicas y barreras de implementación.
Resultados: El telemonitoreo es superior al cuidado estándar, logrando reducciones promedio de 4,8 mmHg en la PA sistólica y 2,1 mmHg en la diastólica, fundamentalmente al facilitar ajustes terapéuticos oportunos. Las intervenciones de salud móvil (mHealth) mejoran significativamente la adherencia a la medicación y la modificación de estilos de vida. Si bien los dispositivos corporales (wearables) y la inteligencia artificial prometen personalizar el cuidado, su implementación enfrenta barreras críticas como la brecha de alfabetización digital en ancianos, la falta de interoperabilidad y desafíos regulatorios.
Conclusiones: La telemedicina es una estrategia eficaz y costoefectiva para mejorar el control tensional y reducir las hospitalizaciones por crisis hipertensivas. Sin embargo, su éxito a gran escala requiere modelos híbridos que combinen la eficiencia tecnológica con la supervisión clínica humana, priorizando la equidad en el acceso digital para evitar exacerbar las disparidades en salud.
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