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We have developed a new home blood pressure (BP) monitoring system by using cellular telephone and the Internet. All data of home BP and pulse rate were directly collected by I-converter date collecting system and sent online to a main server constructed in a central data center. The home doctor can monitor the exercise data of each patient by using this system. This home BP monitoring system was directly connected to the Internet by using application service provider technology (ASP). Anytime and anywhere, each patient can check the changes of these parameters by themselves by using cellular telephone and/or the Internet. The average of the data was calculated and demonstrated online. In real time, all data were monitored and sent to the home doctor's office. In the present study, we tried to use this monitoring system to compare the effect of some antihypertensive drugs on home BP. To compare the effects of telmisartan (TEL) and amlodipine (AM) on home BP, home BP was monitored for eight weeks using this telemedicine system. The target point of office BP was 140/90 mmHg or less. After two weeks control period, telmisartan (TEL group: 20-80 mg/day, n = 21) or amlodipine (AM group: 2.5-10 mg/day, n = 19) was orally administrated once a day in the morning. There was no significant difference of office BP between these two groups. Systolic home BP was significantly decreased from 144 +/- 4 to 134 +/- 3 mmHg (TEL group) and from 143 +/- 4 to 135 +/- 3 mmHg (AM group), respectively. There was no significant difference in the changes of home BP in the morning between groups (eight weeks home systolic BP reduction, TEL: 15 +/- 2 mmHg, AM: 13 +/- 2 mmHg). However the reduction of home BP in the evening in TEL group was significantly bigger than AM group (eight weeks home systolic BP reduction, TEL: 13 +/- 3 vs. AM: 6 +/- 3 mmHg). From these data, we concluded that there is a big difference on the effects of antihypertensive agents on diurnal variation and 24hr overall BP variability in home BP. TEL has a good effect on home BP for 24 hours compared to AM. This telemedicine system has a great advantage in monitoriong home BP correctly in hypertensive patients.

OBJECTIVE We developed a new data collection system named i-converter that could transmit data to a website via cellular phone. Using the system, we compared the effects of two calcium channel blockers on the home blood pressure. METHODS Amlodipine and nifedipine CR were administered to 41 patients with essential hypertension for more than 6 weeks each in a randomized open-label crossover study. The dose of each drug was increased until the home blood pressure reached the target level of under 135/85 mmHg. RESULTS The morning home systolic and diastolic blood pressures were significantly lower during nifedipine CR treatment: 133 +/- 10/81 +/- 8 mmHg with amlodipine versus 131 +/- 8/80 +/- 8 mmHg with nifedipine CR, P < 0.05. The morning pulse rate was significantly higher during nifedipine CR treatment (69 +/- 9 beats/min with amlodipine versus 70 +/- 9 beats/min with nifedipine CR, P < 0.05). The evening home blood pressure and pulse rate, however, showed no significant differences between the two drugs (128 +/- 11/74 +/- 7 mmHg and 74 +/- 10 beats/min with amlodipine versus 128 +/- 10/75 +/- 7 mmHg and 74 +/- 9 beats/min with nifedipine CR, all not significant). CONCLUSIONS Nifedipine CR had a stronger antihypertensive effect than amlodipine during the critical morning period, but the morning pulse rate was higher. Our new data transmission system was effective for collecting precise data on the blood pressure and pulse rate via the internet.

We have been developing a computerized monitoring system for the management of open heart surgery. This system is made up with Engineering Work Station (EWS, TOSHIBA AS4040 etc.), indwelling 32ch. of analog and 2ch. of digital input terminals, and operated with computer graphic program of Data Views (V. I.) on UNIX. Automatic start of system, online data input and mouse device will enable us to use easily in the operating room. Patient monitoring data of ECG, heart rate, body temperature, arterial blood pressure, central venous pressure, pulmonary artery pressure, end tidal CO2 pressure, SpO2 with pulse oximetry, anesthetic gas concentration and heart lung machine data etc. are inputted automatically to the system.