Evidence mapPaperPMID 34455443Full record

Trial reportEuropean heart journal2021

Efficacy of a digital therapeutics system in the management of essential hypertension: the HERB-DH1 pivotal trial.

Kazuomi Kario, Akihiro Nomura, Noriko Harada, Ayako Okura, Kiyose Nakagawa, Tomoyuki Tanigawa, Eisuke Hida

Registry-linked trialAbstract readRandomized Controlled Trial
In one paragraph

Trial report in European heart journal, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT07397260 (Effects of Manually Recorded or Automatically Transmitted Home Blood Pressures With or Without Automated Patient Feedback on Hypertension Care), which is not on this map. Cited by 121 papers, 5 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
121citing papers in PubMed, 5 pooled it
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT07397260 naenrolling by invitationnot on this mapstarted 2026, after this paper: background citation

Effects of Manually Recorded or Automatically Transmitted Home Blood Pressures With or Without Automated Patient Feedback on Hypertension Care

TypeinterventionalSponsorNorthwestern UniversityRan2026 to 2028Enrolled1,304ConditionsHypertension (HTN)ArmsSelf report of home measured blood pressure via patient EHR portal, Automated feedback about home blood pressure results, Automated Transmission of Remotely Measured Blood Pressure
3 · Its place in the literature

Who cites it

121 citing papers in PubMed, 5 syntheses or guidelines pooled it.

  1. Smartphone application-based interventions for cardiometabolic risk factor management: A systematic review and meta-analysis.Hypertension research : official journal of the Japanese Society of Hypertension · 2026
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  4. Smartphone application-based intervention to lower blood pressure: a systematic review and meta-analysis.Hypertension research : official journal of the Japanese Society of Hypertension · 2025
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  18. Home blood pressure-lowering effect of digital therapeutics in hypertension: impact of body weight and salt intake.Hypertension research : official journal of the Japanese Society of Hypertension · 2023
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61 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

7 authors.

Kazuomi KarioDivision of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine, 3311-1, Yakushiji, Shimotsuke, Tochigi 329-0498, Japan.ORCID 0000-0002-8251-4480
Akihiro NomuraInnovative Clinical Research Center, Kanazawa University, 13-1 Takaramachi, Kanazawa, Ishikawa 920-8641, Japan.ORCID 0000-0001-6647-8240
Noriko HaradaDivision of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine, 3311-1, Yakushiji, Shimotsuke, Tochigi 329-0498, Japan.
Ayako OkuraDivision of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine, 3311-1, Yakushiji, Shimotsuke, Tochigi 329-0498, Japan.
Kiyose NakagawaCureApp, Inc., . Kodenma-Cho YS building 4th floor, 12-5 Nihonbashi kodenma-Cho, Chuo-ku, Tokyo 103-0001, Japan.
Tomoyuki TanigawaCureApp, Inc., . Kodenma-Cho YS building 4th floor, 12-5 Nihonbashi kodenma-Cho, Chuo-ku, Tokyo 103-0001, Japan.ORCID 0000-0001-6799-3519
Eisuke HidaDepartment of Biostatistics and Data Science, Osaka University Graduate School of Medicine, Yamadaoka 2-2, Suita-Shi, Osaka 565-0871, Japan.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

aimsDigital therapeutics is a new approach to facilitate the non-pharmacological treatment of hypertension using software programmes such as smartphone applications and/or device algorithms. Based on promising findings from a small pilot trial, the HERB Digital Hypertension 1 (HERB-DH1) pivotal trial investigated the efficacy of digital therapeutics in patients with hypertension not receiving antihypertensive medication. METHODS AND

resultsThis prospective, open-label, randomized controlled study was performed at 12 sites in Japan. Patients with hypertension [office systolic blood pressure (SBP) 140 to <180 mmHg and 24 h SBP ≥130 mmHg] were randomly assigned 1:1 to the digital therapeutics group (HERB system + standard lifestyle modification) or control group (standard lifestyle modification alone). The primary efficacy endpoint was the mean change in 24 h ambulatory SBP from baseline to 12 weeks; key secondary efficacy endpoints were mean changes in office and home blood pressure (BP) from baseline to 12 weeks. All analyses were conducted in the full analysis set population. Between December 2019 and June 2020, 390 patients were randomly assigned to the digital therapeutics group (n = 199) or control (n = 191) group. Between-group differences in 24-h ambulatory, home, and office SBPs at 12 weeks were -2.4 (95% confidence interval -4.5 to -0.3), -4.3 (-6.7 to -1.9), and -3.6 (-6.2 to -1.0) mmHg, respectively. No major programme-related safety events occurred up to 24 weeks.

conclusionThe HERB-DH1 pivotal study showed the superiority of digital therapeutics compared with standard lifestyle modification alone to reduce 24-h ambulatory, home, and office BPs in the absence of antihypertensive medications.

Indexed as

Antihypertensive AgentsHypertensionBlood PressureBlood Pressure Monitoring, AmbulatoryEssential HypertensionHumansProspective StudiesTreatment OutcomeAntihypertensive AgentsAmbulatory blood pressureDigital therapeuticsHome blood pressureHypertensionLifestyle modification

Identifiers

PMID34455443
PMCPMC8530534

What Socratic holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.