| 96

Pensar Enfermagem / v.28 n.01 / October 2024

DOI: 10.56732/pensarenf.v28i1.324

Review Article)

How to cite this article: Dias MR, Ramos AF, Gomes ID. Telenursing in the prevention and management

of cardiovascular risk in older adults with hypertension: a scoping review. Pensar Enf [Internet]. 2024 Oct;

28(1): 96-103. Available from: https://doi.org/10.56732/pensarenf.v28i1.324

TeleNursing in the Prevention and Management of

Cardiovascular Risk in Older Adults with

Hypertension: a Scoping Review

Abstract

Introduction

The global increase in the older adult population has led to a higher demand for healthcare

services, as greater longevity is associated with a rise in the prevalence of chronic conditions

like hypertension (HTN). Geographic barriers and current limitations in healthcare services

pose significant challenges to access, especially for older adults. Various national and

international organizations advocate that telenursing should be widely available to mitigate

these challenges by enhancing care delivery, improving proximity to nursing services, and

achieving better health outcomes.

Objective

To map the available evidence on the contribution of telenursing to the prevention and

management of cardiovascular risk in older adults with HTN.

Methods

Following the Joanna Briggs Institute methodology, we conducted the scoping review and

used the PRISMA-ScR checklist as a complementary guide. We searched the databases

MEDLINE, CINAHL, Open Access Scientific Repository, and Google Scholar for articles

and documents up to May 2023, with no temporal filter.

Results

Seven studies met the inclusion criteria. Six major dimensions characterize the potential of

telenursing in older adults with HTN: cardiovascular risk prevention and management, self-

management of hypertension, improved quality of life, therapeutic adherence, prevention

of clinical inertia, and monitoring of adverse events.

Conclusion

Telenursing contributes to the prevention and management of cardiovascular risk and

fosters a partnership relationship with older adults, supporting self-management of their

health and promoting self-care.

Keywords

Telenursing, Cardiovascular Risk, Hypertension, Older Adults.

Mário Rui Dias1

orcid.org/0009-0000-8232-1198

Ana Filipa Ramos2

orcid.org/0000-0002-4661-0731

Idalina Delfina Gomes3

orcid.org/0000-0003-2974-0734

1 Master’s in Medical-Surgical Nursing – Chronic

Illness Care. Nursing School of Lisbon (ESEL),

Lisbon. Hospital da Luz Lisboa, Lisbon, Portugal.

2 PhD. Nursing School of Lisbon (ESEL), Lisbon.

Nursing Research, Innovation and Development

Centre of Lisbon (CIDNUR), Lisbon, Portugal.

3 PhD. Nursing School of Lisbon (ESEL), Lisbon.

Nursing Research, Innovation and Development

Centre of Lisbon (CIDNUR), Lisbon, Portugal.

Corresponding author

Ana Filipa Ramos

E-mail: anaramos@esel.pt

Received: 29.03.2024

Accepted: 29.10.2024

Pensar Enfermagem / v.28 n.01 / October 2024 | 97

DOI: 10.56732/pensarenf.v28i1.324

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Introduction

The aging population is an inevitable reality that has

significantly shaped healthcare challenges and priorities,

particularly in nursing. According to the National Institute

of Statistics1, projections indicate a concerning ratio of

128,0 to 181,3 older adults per 100 young people, with the

trend expected to double by 2080. This demographic shift

has led to a growing prevalence of chronic diseases (CDs),

affecting 43,9% of the population in Portugal. The World

Health Organization (WHO)2 reported in 2023 that

hypertension (HTN) is the most prevalent

noncommunicable CD, affecting 46% of the global

population, with 1,28 billion adults unaware of their

condition. In Portugal, recent studies3,4 show a 36%

prevalence of HTN, making it one of the leading causes of

mortality. Alarmingly, only 38,9% of those diagnosed with

HTN take medication, and just 28,9% manage to keep their

blood pressure (BP) under control. In hospitals, the

prevalence of HTN among inpatients ranges from 50,5%

to 72%.

HTN is a chronic condition characterized by elevated

blood pressure levels, with values consistently at or above

140/90 mmHg. HTN can be primary (essential) when no

identifiable cause exists or secondary when caused by an

associated disease5,6. Cardiovascular risk refers to the

probability of developing heart and blood vessel diseases,

such as myocardial infarction, stroke, or heart failure. This

risk is influenced by various factors, including HTN,

hypercholesterolemia, diabetes, smoking, obesity, and a

sedentary lifestyle.5,6 Proper management of these

modifiable risk factors can help reduce the likelihood of

severe cardiovascular events.5,6

Given this challenging scenario, there is a need for

innovative and sustainable strategies to address issues

related to aging and chronic diseases. In 2021, the WHO2,

amid the COVID-19 pandemic, outlined the “Global

Strategy on Digital Health,” aiming to promote the

appropriate use of digital resources and adaptable

technologies across nations to tackle major healthcare

challenges and promote equitable access to these resources,

ensuring that no one is excluded5. Similarly, the Shared

Services of the Ministry of Health (SPMS)7, in 2019,

defined Telehealth in the National Strategic Plan for

TeleHealth (PENTS) as a promising solution that includes

Telenursing (TN) (with teleconsultation and

telemonitoring), proposing to shape the future of nursing

care. Despite being significantly driven by the challenges

posed by the COVID-19 pandemic, TN was already a

reality that needs to persist, evolve, and improve

continuously and systematically, regardless of that

exceptional situation.7

Nursing TeleConsultation (TC) can be defined as a

consultation where the nurse, remotely and using various

technologies, assesses a person’s clinical situation and plans

the provision of healthcare, representing a significant

advance in preventive, evaluative, diagnostic, and

interventional approaches7. TeleMonitoring (TM), on the

other hand, involves using technologies to remotely

monitor biometric parameters such as blood pressure, heart

rate, capillary glucose, weight, oximetry, and temperature,

which are transmitted to the care provider8. Nurses should

utilize TM whenever necessary to create nursing diagnoses

and consequently plan interventions7. Technology-based

care models have been widely used and enhanced after the

COVID-19 pandemic, especially in the older adult

population.9

Given the findings of previous systematic reviews that

highlight the effectiveness of TE in reducing HTN values10,

particularly systolic blood pressure, cholesterol levels,

self-efficacy, and therapeutic adherence, this review focuses

on a more specific population group, those aged 65 and

older11. This study aims to map existing evidence on the

effectiveness of TE in managing HTN to prevent and

control cardiovascular risk (CR) in older adults (OA). The

study seeks to contribute significantly to advancing nursing

care by providing important insights into the effective

implementation of this innovative approach in the context

of population aging and chronic diseases.

Methods

This scoping review followed the Joanna Briggs Institute

(JBI) methodology.12 The search strategy and article

analysis adhered to the guidelines for systematic reviews

and meta-analysis extensions, specifically PRISMA-ScR.13

We registered the protocol on the Open Science

Framework (OSF) at Open Science Framework (OSF)

osf.io/76pnm to avoid duplicating scientific evidence.

Selection criteria

The inclusion and exclusion criteria were established based

on the Population, Concept, and Context (PCC)

framework, following the JBI’s guiding principles. We

formulated the research question: What is the contribution

of Nursing Teleconsultation (C) to the prevention and

control of cardiovascular risk in older adults with

hypertension (P) across various contexts (C)?

Population: Individuals aged 65 and older, with or without

controlled hypertension;

Concept: Contributions of teleconsultation in the

prevention and control of HTN and cardiovascular risk

(CR);

Context: Any healthcare setting.

We excluded articles unrelated to the research question or

nursing care, those without defined objectives, and those of

an editorial or opinion nature. This review included studies

with qualitative, quantitative, and mixed designs,

incorporating previous systematic reviews addressing the

98 | Dias, MR.

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research question, with no restrictions on language or

timeframe.

Search strategy

To validate the novelty of the topic under study,

we searched various databases on May 19, 2023, including

PubMed, JBI Evidence Synthesis, and PROSPERO, and

found no completed or registered scoping review

protocols. Following the Peer Review of the Electronic

Search Strategies checklist9, two authors (M.D. and A.R.)

developed the search strategy, which was validated by a

third author (I.G.).

We utilized MEDLINE (via PubMed) and CINAHL

Complete (EBSCOhost) electronic databases for article

searches. The descriptors were validated in the Medical

Subject Headings (MeSH) to ensure a high-quality selection

and data extraction process. The search strategy is detailed

in Table 1. We also used Google Scholar and the Open

Access Scientific Repository in Portugal, guided by the

same temporal delimitation, with descriptors validated in

Health Sciences (DeSC).

Table 1 - MEDLINE (EBSCOhost) and CINAHL

Complete (EBSCOhost) search strategy conducted on

05/19/2023

Descriptors

“tele*”

“Hipert* OR Cardiov* Risk”

“Aged: 65+ years”

“nurs*”

[“tele*” AND (“Hipert* OR Cardiov* Risk”) AND

“Aged: 65+ years” AND “nurs*”]

Article selection process and eligibility criteria

We extracted all documents based on their title and

abstract, aligning them with the defined scoping review

objective. Duplicate articles were removed using

Mendeley® 19.4 (Mendeley Ltd., Elsevier, Amsterdam, The

Netherlands). We extracted and organized data as follows:

author(s), year and country of study, objective,

methodology, population/sample size, and the

contribution of TN to the prevention and control of

cardiovascular risk in OA. Any disagreements regarding the

inclusion of reports were resolved through discussion with

a third reviewer.

Results

Characteristics of Included Studies, Context, and

Population

The initial search identified 49 articles. After removing

duplicates (n=2) and excluding articles with participants

under 65 years of age (n=10), 37 articles remained. Further

analysis of titles and abstracts led to the exclusion of 1

unrelated article and 10 due to lack of full-text access,

leaving 26 eligible articles. Upon review, 22 were found to

involve populations under 65 years, resulting in 7 articles

for detailed analysis. These selected studies, from six

different countries, are discussed and synthesized in this

paper, as shown in Figure 1.

The included articles originated from the United States

(n=2), Canada (n=1), Spain (n=1), Brazil (n=1), Japan

(n=1), and the United Kingdom (n=1). The study designs

include randomized controlled trials (n=2), observational

studies (n=2), cross-sectional descriptive quantitative

(n=1), qualitative studies (n=1), and a narrative review.

Table 2 summarizes the extracted information, including

author/year of publication, main objective, methodology,

sample/population under study, care context, and concept.

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Figure 1. PRISMA flowchart of the article and publication selection process

Table 2. Systematization of articles and publications included in the scoping review

Author(s)/

Year of

publication/

Country

Objective

Methodology

Population/

Sample composition/ Care

context

Contributions of telenursing to the

prevention and control of cardiovascular

risk in older adults with hypertension

Millan-

Calenti et

al.15, 2016

Espanha

Define the profile,

medication

consumption patterns,

and frequency of

diseases among

teleassistance users.

Descriptive cross-

sectional study

Study duration: six

months.

Regular calls + SOS

service.

742 older adults (men and

women) over 65 years using

teleassistance;

75% were on cardiovascular

medication;

Mean age: 83.3 years;

Comorbidity of 2,8

diseases/person;

51,1% with hypertension

(HTN), 34,7% with myocardial

infarction and heart failure.

Outpatient care.

Reduces the need for travel; provides regular

monitoring;

Improves QoL for OA and caregivers;

Decreases hospitalization rates;

Enhances self-management of HTN and BP

control in older adults;

Increases medication adherence;

Suitable for individuals with mobility issues;

Reduces incidence, severity, and costs

associated with falls.

Adie et al.16,

2010

Reino unido

Investigate whether

telephonic follow-up

for blood pressure

control improved risk

factor management in

individuals with CVA

or TIA.

Randomized

controlled study

Study duration: six

months.

Initial contact + TC at

the end of six months.

56 individuals (men and women)

over 18 years old with a stroke

or transient ischemic attack 1

month ago;

27 received usual care, 29 usual

care plus TN;

Mean age: 72.5 years;

69.7% with HTN; 21,5% with

hypercholesterolemia.

43% with TIA, 57% with minor

stroke, 12,5% with previous

stroke and TIA;

18% smokers.

Outpatient care.

Lowers BP in both groups;

Improves medication knowledge in the TC

group;

Significantly reduces total cholesterol in both

groups;

Smoking cessation in TC group;

Reduces recurrence of stroke and transient

ischemic attack;

Highlights time limitations and small sample

size;

Insufficient for improving adherence;

Recommends motivational interviewing;

Patients maintained contact with hospitals.

Studies identified in

EBSCOhost

CINAHL=21

MEDLINE= 28

100 | Dias, MR.

Review Article

Jensen et

al.17, 2009

Estados

Unidos

Describe healthcare-

seeking behavior and

cardiovascular risk-

reducing therapies

provided to high-risk

participants at a health

fair.

Observational study

Study duration: one

month.

Teleconsultation one

month after initial

contact.

447 participants (men and

women) over 18 years old at

high CVD risk;

Mean age: 69 years;

62% with HTN;

Smokers (14,3%), diabetes

(50%), hypercholesterolemia

(47,4%).

HCC: Angina (16.6%), MI

(9,6%), Coronary

revascularization (12,3%); No

control group;

Outpatient care.

Motivates seeking healthcare professionals or

scheduling appointments;

Encourages self-knowledge about the disease,

CR, diet, and exercise;

Improves healthcare adherence;

Fosters a sense of empowerment;

Prompts healthcare professionals to

implement and enhance strategies to reduce

CR;

Only one study addressed smoking cessation;

Recommends longer TC duration and

effective messaging;

Suggests motivational interviewing.

Correia et

al.18, 2020

Brasil

Report on the use of

nursing teleorientation

for hypertensive

patients in social

isolation under

specialized outpatient

care.

Experience report

(qualitative)

Study duration: April

7-10, 2020, during the

pandemic (social

isolation).

Daily phone contact.

53 participants (men and

women) over 60 years with

resistant HTN:

27 in the TM group, 26 in the

control group;

Mean age: 69 years;

Outpatient care;

Weekly video calls.

Avoided travel during the pandemic;

Strengthen trust with healthcare professionals;

Reinforces self-care, medication adherence,

and dietary care;

Promoted active listening during isolation and

reduced loneliness;

Enhances QoL.

Idris et al.19,

2015

Estados

Unidos

Determine the

practicality and

acceptability of a novel

home TM system

(Health Connect).

Randomized

controlled study

Study duration: 3

months. Weekly video

calls.

28 participants (men and

women) over 65 years old with

NYHA class II/III systolic heart

failure and LVEF 35%:

14 in the TM group and 14 in

the control group;

Mean age: 69 years;

96% with HTN;

Smokers (39%), diabetes (57%);

Dyslipidemia (67%);

HCC: Angina (32%)

Outpatient care.

Decreased readmission rates in the TM group;

Additional benefit from virtual consultations

with healthcare professionals;

Fosters a sense of empowerment—patients

gain insight and awareness about the disease;

Promotes medication adherence;

Ideal opportunity for patient education;

Reports high patient satisfaction;

Detects changes in vital signs enabling early

healthcare intervention;

No significant difference in hospital

readmission or death between groups.

Padwal et

al.20, 2018

Canadá

Compare the cost-

effectiveness of TM

versus usual care in

older adults with

cerebrovascular disease

in residential facilities.

Observational study.

Study duration: 3

months, then quarterly

for 20 years.

279 participants with a recent

minor cerebrovascular event;

Mean age: 67,6 years.

Cost savings, improved QoL, and health

outcomes;

Reduces the number of strokes, MI, unstable

angina, and deaths in the TM group;

Lowers BP in the TM group; Recommends

strategies and funding for widespread

implementation of TM;

Suggests case management.

Fujiwara et

al.21, 2023

Japão

Address and discuss

current evidence on

TM systems for

managing HTN in

older adults.

Narrative review.

Older adults over 65 years in

telemonitoring;

People with HTN.

Reduces CVD risk;

Prevents falls and postural hypotension;

Identifies masked HTN;

Detects seasonal variations;

Reduces workload;

Provides accurate BP reporting;

Mitigates some patient technological illiteracy;

Identifies potential non-adherence and

prevents complications;

Offers comprehensive estimates of average

BP levels;

Improves education and communication with

physicians;

Reduces risk of syncope and falls;

Decreases geographic barriers;

Reduces unnecessary office visits;

Enhances disease self-management;

Provides access to high-quality healthcare in

remote areas;

Better BP control and prevention of adverse

events.

HCC = history of cardiovascular conditions; CVA/stroke = cerebrovascular accident; TIA = transient ischemic attack; CV = cardiovascular; CAD = coronary

artery disease; CVD = cardiovascular disease; MI = myocardial infarction; QoL = quality of life; BP = blood pressure; TC = teleconsultation; TM =

telemedicine.

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Discussion

To analyze the collected data, we adopted an approach

based on the various dimensions identified concerning TN

contributions: control and prevention of cardiovascular

risk (CR), disease self-management, quality of life (QoL)

improvement, therapeutic adherence, clinical inertia, and

monitoring and prevention of adverse events.

CR control and prevention

We identified that TN is a promising tool for CR

management by promoting self-care, therapeutic

adherence, and healthy eating habits, as reported by Correia

et al.18. Adie et al.16 emphasized TN’s role in regular

hospital contact and effective blood pressure (BP)

reduction among groups using telemedicine. As highlighted

by Padwal et al.20, this BP reduction is directly linked to a

decreased risk of cardiovascular diseases.

Another significant point is telemedicine’s ability to identify

masked hypertension, detect seasonal variations, and

provide comprehensive estimates of average BP levels.21

These elements are crucial for a personalized and effective

intervention in cardiovascular risk prevention and control.

Jensen et al.17 emphasize that TN not only encourages

regular contact with healthcare professionals but also

actively promotes seeking knowledge about their condition

and cardiovascular risk factors. This empowerment

dynamic helps individuals gain health awareness,

encouraging healthy lifestyle habits like a balanced diet and

regular exercise. Moreover, TN effectively addresses

patients’ technological illiteracy, as observed by Fujiwara et

al.21. Overcoming these technological barriers is essential to

ensuring equitable access to the benefits of TN for all

populations in cardiovascular risk prevention and

management. The findings from Idris et al19 show high user

satisfaction with TN, reinforcing the positive acceptance of

this approach.

The significant reduction in total cholesterol and smoking

cessation among individuals participating in TC further

highlights the effectiveness of TC in overall cardiovascular

health management.17

Disease self-management (hypertension)

Evidence suggests that TN plays a crucial role in improving

hypertension self-management among older adults16,18,20.

Regular monitoring of BP levels has led to significant

reductions, both in community settings16 and institutional

environments21. Additionally, TC has encouraged frequent

contact with healthcare professionals, resulting in regular

appointment scheduling, which is vital for HTN control17.

The empowerment dynamic facilitated by TC is evident as

clients gain a deeper understanding, awareness, and

knowledge of the disease and CV risk.17,19

Quality of life (QoL)

TN has shown positive impacts on QoL for both older

adults18,20,17 and caregivers12. This improvement in QoL is

reflected in reduced readmission rates17,21 and overall health

enhancement.10

Compared to hospital admissions, the cost savings

associated with teleconsultations further highlight the

model’s effectiveness.17,20 High satisfaction rates among

individuals indicate a positive acceptance of this

approach15, underscoring the importance of considering

patient experiences when developing teleconsultation

services. Additionally, there was a decrease in the

recurrence of stroke and transient ischemic attack16,12 and a

reduction in cardiovascular disease risk.10,20

Therapeutic adherence

TN has emerged as a significant facilitator for improving

therapeutic adherence among older adults.16,18,19,21

Enhanced medication knowledge in the teleconsultation

group, where issues related to medication regimen

management were addressed16,20, and the early detection of

potential non-adherence18 contributed to

positive outcomes.

Prevention of clinical inertia

TN not only strengthens the trust between healthcare

professionals and patients18 but also motivates

professionals to implement more effective strategies to

reduce cardiovascular risk17. Early detection of vital sign

changes19, identification of masked hypertension, and

reduced workload through self-recorded data

transmission18 allow for timely healthcare interventions19.

Additionally, TN provides comprehensive BP estimates

and improves communication with physicians18. It offers

an ideal opportunity for patient education, emphasizing its

role in both treatment and prevention.19

Monitoring and prevention of adverse events

Regular monitoring enabled by TN contributes to

preventing adverse events20, especially among more

vulnerable populations, such as institutionalized clients.

The reduction in the risk of syncope and falls is particularly

noteworthy, highlighting the importance of

teleconsultation in ensuring patient safety21. Adie et al.16

observed a significant decrease in the number of events,

including strokes, myocardial infarctions, unstable angina,

and mortality, in the group utilizing telemedicine. Findings

from Padwal et al.20 support this reduction, reinforcing the

effectiveness of telemedicine in preventing these critical

events. These results underscore the value of TN as a

crucial tool in managing and preventing adverse ischemic

events.

Although not directly linked to cardiovascular risk

prevention, frailty in OA is a vital consideration when

examining the benefits of nursing teleconsultation. Studies

by Fujiwara et al.21 and Millan-Calenti et al.15 highlight

102 | Dias, MR.

Review Article

teleconsultation’s ability to prevent incidence, reduce

severity, and minimize costs associated with falls and

postural hypotension, two significant challenges for frail

older adults. Fujiwara et al.21 also emphasize that

teleconsultation can overcome technological illiteracy

among clients, eliminating barriers that could impede

access to healthcare. Both Millan-Calenti et al.15 and

Fujiwara et al.21 indicate that teleconsultation reduces

unnecessary travel, providing convenience and easing the

logistical burden for those in fragile conditions. As

Millan-Calenti et al.15 noted, teleconsultation is particularly

suitable for individuals with mobility limitations, offering

an accessible and effective alternative for obtaining

healthcare. Fujiwara et al.21 further emphasize the ability of

teleconsultation to overcome geographical barriers,

providing a crucial opportunity for access to high-quality

healthcare in remote areas, surpassing the traditional

challenges of distance. Correia et al.18 highlight that TC not

only promotes active listening but also reduces loneliness,

especially during periods of social isolation, and its utility in

avoiding travel during pandemics, offering a safe and

effective solution.

Conclusion

TN emerges as a significant catalyst for digital

transformation in healthcare, enhancing accessibility and

proximity to nursing care.22-24 It offers a comprehensive

and effective approach for preventing and managing

vascular risk in OA with HTN. It delivers substantial

benefits in disease self-management, QoL, therapeutic

adherence, clinical inertia, and adverse event monitoring.

The mapped evidence suggests that broader integration of

TC into nursing practice could be a valuable strategy for

cardiovascular health management, particularly in

populations with greater frailty and vulnerability.

Several studies have highlighted the effectiveness of TN;

however, it remains underexplored in people aged 65 and

older. Future studies should focus on evaluating the

effectiveness of TN, clarifying the nursing intervention

components that promote hypertension control, and

enhancing the quality and safety of TN use. Additionally,

research should investigate the expectations and needs of

older adults regarding TN and the health outcomes

reported by these individuals.

Study limitations

The inability to retrieve articles without full text available

could be a limitation of this review, as it might have

contributed new data to the synthesized evidence.

Authors’ contributions

Dias, Mário R: Conception and design of the study;

Collection of data; Analysis and interpretation of data;

Statistical analysis; Writing of the manuscript; Critical

revision of the manuscript

Ramos, Ana F: Conception and design of the study;

Collection of data; Analysis and interpretation of data;

Statistical analysis; Writing of the manuscript; Critical

revision of the manuscript

Gomes, Idalina D: Conception and design of the study;

Collection of data; Analysis and interpretation of data;

Statistical analysis; Writing of the manuscript; Critical

revision of the manuscript

Conflicts of interest and Funding

No conflicts of interest were declared by the authors.

Sources of support / Financing

The study was not funded.

References

1. Instituto Nacional de Estatística (INE). Tábuas de

mortalidade para Portugal 2019-2021 [Internet].

Lisboa: INE; 2022 [cited 2023 May 17]. Available

from:

https://www.ine.pt/ngt_server/attachfileu.jsp?look_

parentBoui=577174880&att_display=n&att_downloa

d=y

2. Organização Mundial de Saúde (OMS). Global

strategy on digital health 2020-2025 [Internet].

Geneva: OMS; 2021 [cited 2023 May 17]. Available

from :

https://www.who.int/publications/i/item/97892400

20924

3. Santos TASL. Hipertensão arterial em Portugal: O

custo do controlo [Dissertação de Mestrado na

Internet]. Coimbra: Faculdade de Medicina da

Universidade de Coimbra; 2019 [cited 2023 Jun 10]. D

Available: http://hdl.handle.net/10316/97732.

4. Amado C, Leal M, Valente T, Aveiro M, Ribeiro F,

Cruz M. A. Hipertensão arterial num dia de

internamento: Caracterização de um dia de

internamento. Rev Port Hipertens Risco Cardiovasc.

2020; 79: 6-25.

5. Whelton PK, Carey RM, Aronow WS et al. 2017

ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/AS

H/ ASPC/NMA/PCNA guideline for the prevention,

detection, evaluation, and management of high blood

pressure in adults: Executive summary: A report of the

American college of cardiology/American Heart

Association task force on clinical practice

guidelines. Hypertension [Internet]. 2018 [cited 2024

Jul 15];71(6):1269-1324. Available from:

https://doi.org/10.1161/HYP.0000000000000066.

6. Williams B, Mancia G, Spiering W, et al. 2018

ESC/ESH Guidelines for the management of arterial

Pensar Enfermagem / v.28 n.01 / October 2024 | 103

DOI: 10.56732/pensarenf.v28i1.324

Review Article

hypertension. Eur Heart Jl. [Internet]. 2018 Sep [cited

2024 Jul 15];39(33):3021-3104. Available

from: https://doi.org/10.1093/eurheartj/ehy339

7. Ordem dos Enfermeiros (OE). Consultas de

enfermagem à distância, Teleenfermagem: Guia de

recomendações. Lisboa: OE; 2021.

8. Serviços Partilhados do Ministério da Saúde (SPMS).

Plano Estratégico Nacional para a Telessaúde. Lisboa:

SPMS; 2019.

9. Quesada-Caballero M, Carmona-García A, Chami-

Peña S, et al. Telemedicine in elderly hypertensive and

patients with chronic diseases during the COVID-19

Pandemic: A systematic review and meta-analysis. J

Clin Med. [Internet]. 2023 [cited 2024 Jul

15];12(19):6160. Available from:

https://doi.org/10.3390/jcm12196160.

10. Choi WS, Kim NS, Kim AY, Woo HS. Nurse-

coordinated blood pressure telemonitoring for urban

hypertensive patients: A systematic review and meta-

analysis. Int J Environ Res Public Health. [Internet].

2021 [cited 2024 Jul 15];18(13):6892. Available from:

https://doi.org/10.3390/ijerph18136892.

11. Kappes M, Espinoza P, Jara V, Hall A. Nurse-led

telehealth intervention effectiveness on reducing

hypertension: a systematic review. BMC Nurs

[Internet]. 2023 [cited 2024 Jul 15];22(1):19. Available

from: https://doi.org/10.1186/s12912-022-01170-z.

12. Peters MDJ, Marnie C, Tricco AC, et al. Updated

methodological guidance for the conduct of scoping

reviews. JBI Evid Synth. [Internet] 2020 [cited 2023

May 17];18(10):2119-2126. Available from:

https://doi.org/10.11124/JBIES-20-00167.

13. Tricco AC, Lillie E, Zarin W et al. PRISMA Extension

for Scoping Reviews (PRISMA-ScR): Checklist and

Explanation. Ann Intern Med. [Internet] 2018 [cited

2023 May 17];169(7):467–473. Available from:

https://doi.org/10.7326/M18-0850.

14. McGowan J, Sampson M, Salzwedel DM, Cogo E,

Foerster V, Lefebvre C. PRESS Peer Review of

Electronic Search Strategies: 2015 Guideline

Statement. J Clin Epidemiol. [Internet] 2016 [cited

2023 Jun 5];75:40–46. Available from:

http://dx.doi.org/10.1016/j.jclinepi.2016.01.021.

15. Millán-Calenti JC, Martínez-Isasi S, Lorenzo-López L,

Maseda A. Morbidity and medication consumption

among users of home telecare services. Health Soc

Care Community. [Internet] 2016 [cited 2023 May

17];25(3):888-900. Available from:

https://doi.org/10.1111/hsc.12377

16. Adie K, James MA. Does telephone follow-up

improve blood pressure after minor stroke or TIA?

Age Ageing [Internet]. 2010 Sep [cited 2023 Jun

5];39(5):598-603. Available from:

https://doi.org/10.1093/ageing/afq085

17. Jensen L, Leeman-Castillo B, Coronel SM, Perry D,

Belz C, Kapral C, Krantz MJ. Impact of a nurse

telephone intervention among high-cardiovascular-

risk, health fair participants. J Cardiovasc Nurs

[Internet] 2009 [cited 2023 Jun 5];24(6):447-453.

Available from:

https://doi.org/10.1097/JCN.0b013e3181b246d9

18. Correia DMDS, Pimentel ACE, Costa LBD et al.

Teleorientação a hipertensos resistentes durante a

pandemia por COVID-19: uma ação inovadora na

enfermagem. Enferm Foco [Internet]. 2020 [cited

2023 Jun 5];11(ESP.2):179-184. Available from:

DOI: 10.21675/2357-707X.2020.v11.n2.ESP.3860

19. Idris S, Degheim G, Ghalayini W, Larsen TR, Nejad

D, David S. Home telemedicine in heart failure: a pilot

study of integrated telemonitoring and virtual provider

appointments. Rev Cardiovasc Med. [Internet] 2015

[cited 2023 Jun 5];16(2):156-162. Available from:

https://doi.org/10.3909/ricm0760.

20. Padwal RS, So H, Wood PW et al. Cost-effectiveness

of home blood pressure telemonitoring and case

management in the secondary prevention of

cerebrovascular disease in Canada. J Clin Hypertens

(Greenwich) [Internet]. 2019 [cited 2023 Jun

5];21(2):159-168. Available from:

https://doi.org/10.1111/jch.13459.

21. Fujiwara T, Sheppard JP, Hoshide S, Kario K,

McManus RJ. Medical Telemonitoring for the

Management of Hypertension in Older Patients in

Japan. Int J Environ Res Public Health [Internet]. 2023

[cited 2023 Jun 5];20(3):2227. Available from:

https://doi.org/10.3390/ijerph20032227

22. Gomes ID, Silva LV, Karina G, Sobreira LS, Souza

MCMR, Souto RQ. Age-Friendly Primary Health

Care: A Scoping Review. In: García-Alonso, J.,

Fonseca, C. (eds) Gerontechnology IV. Cham:

Springer; 2022. p. 94-107. Available from:

https://doi.org/10.1007/978-3-030-97524-1_10

23. World Health Organization. Non-communicable

diseases [Internet]. Geneva: WHO; c2024 Available

from: https://www.who.int/news-room/fact-

sheets/detail/noncommunicable-diseases.

24. World Health Organization. Recommendations on

digital interventions for health system strengthening.

[Internet] Geneva: WHO; 2019. Available from:

https://iris.who.int/handle/10665/311980.